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86 JANUARY-MARCH 2015
THE JOURNAL OF INSURANCE INSTITUTE OF INDIA
Abstract
India Motor Tariff was abolished in 2007,
but its provisions and wordings were kept
in force. Unfortunately broader market still
functions under tariff mindset. Rates are
quoted as Tariff-x% and interpretation of
tariff is used for own benefit.
With the new age marketing channels,
insured is often trapped in mis-selling.
Unfriendly and complex legal languages of
policy add to insured’s nuisance.
Author observes number of anomalies in
provisions of the tariff. Besides critically
Peeyush Agarwal
Head – Operations and Business Project
Lead (Legacy System Transformation)
Tata AIG General Insurance Company
Limited, 225, Vasundhara,
Thakur Village, Kandivali East,
Mumbai - 400101.
peeyagarwal@gmail.com
Motor Insurance – Tariff, Detariff and Beyond…
analyzing such provisions, research paper
suggests alternate options in detail. For
internal control of the industry, post
taking the tariff off, suggestive guide
regulations and insured friendly policy
wording is annexed. Paper suggests
simple provisions, merging of similar
endorsements, transparent quoting and
use of simple warranties than complex
endorsements.
Simplification is the need of the hour.
Residual tariff should be taken off and
industry should develop on demand &
supply and insurer’s perception of risk.
MOTOR INSURANCE
87JANUARY-MARCH 2015
THE JOURNAL OF INSURANCE INSTITUTE OF INDIA
Keywords
Motor Insurance, India Motor Tariff,
Simplifying Insurance, Beyond Tariff,
Customer Friendly Policy Wording
Motor Insurance is risky, long tailed, loss
prone etc. are various phrases commonly
used in non-life insurance parlance. Yet it
remains the largest contributor making it
difficult for any general insurer to survive
without underwriting motor business. In
India as well, motor historically constitute
around 45% of gross premium (Graph 1).
Graph 1: Segment-wise share in Gross
Direct Premium in India (2007 – 2013)
Motor Vehicles are highly regulated
including liabilities arising out of use of
the vehicle. So is its insurance. Motor
insurance was put under tariff in 1970
after TAC came into existence. Tariff saw
various revisions with changing times.
Finally effective 1st
January 2007, Tariff
was abolished keeping the policy terms
intact and rates regulated under File and
Use Guidelines. Third party premiums
were kept under control. Since then
industry has come a long way yet not
able to come out of tariff mindset. Tariff
rates somehow became a benchmark akin
to MRP and discounts offered on these
as if a sale is going on. Add-on products
allowed effective 1st
January 2009 and lot
of value added for the insured.
Few complexities are noted in tariff
leaving options for companies to interpret
differently. The judiciary also would give
benefit of doubt to insured that might
arise because of ambiguity, complexity
or fine print in regulations / wordings.
Difficult to understand legal kind of
language tend the client not to read the
document and rely on verbal information
thus falling under the trap of misselling.
Time has come, when Market should step
further with more reforms and simpler
products and wordings. Legal language
should be replaced with common man
friendly language. Tariff should be
completely removed and market should be
left free to the extent feasible.
Similar are the recommendations of recent
working group on revision of File and Use
Guidelines.
Complexities of Tariff
1. There are 3 broad categories – Private
Car, Two Wheeler and Commercial
Vehicles. Commercial Vehicles are
sub-divided on their class and usage.
This classification doesn’t run neck
to neck with definitions of law and
leaves subjectivity. E.g. a private car
type vehicle (Omni bus), running
as private service vehicle (transport
vehicle but not for hire or reward),
leaves scope to be covered under
private car or commercial vehicle.
The ambiguity about classification
of dumper / tipper / semi-trailer as
miscellaneous or goods carrying
has been a matter of debate for long.
There are no differences according
to actual usage within the categories
e.g. stage carriage / contact carriage /
educational institution bus etc.,
where usage and risk exposures are
clearly different.
2. There is one special provision related
to trailers, which is really difficult
to adhere to. Tractor and Trailer
can be covered in a single policy or
separately. But trailer tariff stipulates
that proposer need to specify the
count of trailer he wish to attach with
the tractor. How would he decide
upfront? Depending upon need
number of trailers are attached. If
both are covered in same policy, can
he not attach the same trailer with
any other tractor?
3. There are 4 types of policy formats
– Liability Only and Package Policies
for Private Car, Two Wheeler and
Commercial Vehicle. Referring
Table 1, we see, there is hardly any
difference that necessitates three
different formats. For third party
risks, mandatory legal risk is to be
covered. For damage to vehicle, any
vehicle is exposed to same risks
and perils. There may be difference
in scale of hazard, probability of
occurrence of peril and resultant loss
severities.
4. There are 49 General Regulations and
many of these are related to rating.
Rates are deregulated and almost all
insurers have inbuilt most of them in
their base pricing. Other important
aspect is with regard to abolition of
tariff. Would any of its regulation that
is not part of proposal or policy be
legally binding on the insured?
MOTOR INSURANCE
50
45
40
35
30
25
20
15
10
5
0
42.95
45.59
2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13
Source: IRDA Annual Reports Financial Year
Graph 1 Fire Marine Motor Health Others
43.94 43.46 42.7
45.84 47.05
Segment-wise Share in GDP
88 JANUARY-MARCH 2015
THE JOURNAL OF INSURANCE INSTITUTE OF INDIA
Existing Deductible limits were set
long ago. There are upward changes
effected recently but for private car
and two wheelers only. Main purpose
of excess is to avoid high frequency
of low severity claims. Insured gains
through reduced premium and also
hassle of claiming, whatever minimal
it may be. Insurer saves huge cost of
servicing claims, which at times may
be more than claim amount. It should
be left open for insured and insurer as
a pricing parameter. Innovations like
franchise and differentiated deductible
for different perils should be explored.
E.g. theft prone vehicles may have
higher deductible for peril ‘theft’ to
force insured taking better security
measures. Special endorsements
or warranties may have higher
deductibles, instead of repudiating
full claim, if insured is unable to
fulfill requirement. This would not
only enrich the data base for further
in depth actuarial analysis but also
improve the obligations from insured
side.
5. Good driving history is primarily a
rating consideration. No reasons that
person claiming once or thrice enjoy
same benefit in rates. No Claim Bonus
provisions of the tariff are complex
and raise lot of confusions. Some
provisions follows the insured e.g.
substitution, and others the vehicle
e.g. fleet. Sometimes we may get
benefit without being eligible like
conversion from restricted to package
without ascertaining any loss by
accidental external means. Sometimes
we may lose the NCB for technical
reasons only like transfer of vehicle
from employee to employer with user
remaining same. NCB on declaration
basis is another provision, which is
abused like anything.
No doubt NCB is one of the strongest
features, however in post de-tariff
era, this should follow more logical
and broader relation between insured
and vehicle. Ideally this should be left
for insurers as one of the important
rating factors. Many countries follow
it differently. Instead of fixed NCB,
a claim history certificate is issued
by the insurer. This certificate is
submitted to the insurer and evaluated
for rating by underwriters.
For leakage on declaration basis,
Insurance Information Bureau of
India has taken number of steps. But
lag in upload of data on IIB site has
impacted the desired results. Insurers
must come together and leverage IT
platforms for real time confirmations
of claim status through Web-service.
6. There should not be any justification
for difference in cover offered like
occupants under standalone Liability
Policy and Package Policy without
having difference in premium.
Regulating rates for mandatory Third
Party Cover are understandable
but not extra covers like personal
accident, wider legal liability etc. For
sure, we can argue that it is only the
mandatory base liability cover, which
affects mass and not extra benefits.
It would be of interest to discuss few
such extra benefits.
Under Personal Accident (PA), all
occupants, whether it is insured
self or paid driver, family / friend,
employee or any other human being,
have same exposure of accidental
death / injury, yet there are different
clauses / endorsements in the tariff
with similar cover. Result is insured
end up paying for more persons
than the number of occupants that
can be present in the vehicle at any
point of time. Example – one has
to pay for owner driver, paid driver
and 5 (seating capacity) unnamed
passengers i.e. for total 7 if he wishes
to cover all eventualities. Secondly, if
person has more than one vehicle he
ends up paying for self on all vehicles,
where he can be present in maximum
one vehicle at a time.
Under Wider Legal Liability, there
is different coverage under different
sections for various types of classes /
occupants. Most of these are available
at ` 50/- per capita and covers liability
under Workmen’s Compensation
Act, Fatal Accidents Act & Common
Law. Major difference is availability
of liability under WC Act to persons
employed in relation to vehicle. Cover
is available with first obligation of
payment under WC policy, which
means premium remain same
irrespective of one has a WC policy or
not. Like PA, one has to pay for more
than seating capacity e.g. paid driver
and employees are covered under
endorsement 28 & 29. Under 28,
payment for 1 (driver) and under 29,
for 5 (including driver) thus paying for
6. Another complex provision under
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THE JOURNAL OF INSURANCE INSTITUTE OF INDIA
two wheeler tariff is that premium
rate is ` 50/- per employee under
endorsement 28 but ` 60/- under
endorsement 29, whereas risk is wider
under endorsement 28. Same situation
is with endorsement 37 / 38 & 39.
There is no noticeable difference in
endorsement 28 & 40.
It would be pertinent to free at least
extra covers. Let proposer pay
for the cost of actual risk. Similar
endorsements should be clubbed to
form single endorsement. On par with
own damage section, value added add-
on covers should be allowed under
Liability section as well. Few examples
may be PA for higher amounts,
unlimited third party property
damage, easy re-imbursement of
medical expenses, re-imbursement of
counsel’s fee and other legal charges
for defending criminal case / bail
associated with covered accident
etc. Even process should be decided,
obviously with legal standing, to
support easy and hassle free out of
court settlements for liability.
7. Tariff carried wordings for 54 different
endorsements (excluding ones related
to Motor Trade Tariff). These require
restructuring and including only few
in guide. Rating related to be removed
and similar ones to be clubbed. Even
financiers’ interest related IMT #
5, 6 and 7 can also be combined,
at least 5 and 7. The declaration /
representations by insured in proposal
form would remain important under
basic insurance principle of utmost
good faith.
8. There are at least 17 different
limitation clauses in the tariff. Mostly
they are similar with only minor
differences. Even these are not proved
sufficient to curb wrong classification
of vehicles like dumper.
With only policy format, as suggested
above, there should be only one
limitation and or driver clause.
This should restrict usage as per
registration class and permit of
the vehicle and may cover other
specialized usage like racing etc.
9. A clause inserted as warranty is easier
to understand and follow than a full
fledged endorsement. As such some
endorsements can be converted into
a warranty. These may further be
tagged with specific clauses of higher
deductible, if not fulfilled.
Old saying is ‘The Only Thing That
Is Constant Is Change.’ Similarly
Table 1 – Differences in Policy Wordings (other than Cosmetic Differences)
Parameter Liability
Only
Private
Car
Two Wheeler Commercial Vehicle
Towing Charges NA 1500/- 300/- 750/-, 1500/- or 2500/-
depending upon class
Insured’s Authority
for Repair
NA 500/- 150/- 500/-
Deductible NA 1000/- or
2000/-
100/- 500/- to 2000/- or above
depending upon class
Exclusions (only
additional or
differences)
- Theft of
Accessories
- Theft of Accessories
- Overloading
IDV - Mention of
Side Car
Sections - One more Section
covering Towing
Disabled Vehicle
- Rule 129, 131, 132, 133
are reproduced from
Central MV Rules
Conditions One extra condition about
relinquishing of company
after paying to the insured
Section II –
Liabilities to Third
Parties
Differences are observed, whereas this intend to cover liability as
enumerated in MV Act
Note – Limits under 1st
three items were set way back in 2002 (minor revision
in deductible for private car and two wheeler recently). Cost since then has risen
multifold. All these items should be left to insurers and should be driven by rating for
better control.
MOTOR INSURANCE
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THE JOURNAL OF INSURANCE INSTITUTE OF INDIA
achieving a perfect state is only
theory. Innovations are there because
scope of improvement and betterment
is there. Industry should come out of
tariff mentality and should differentiate
on products and servicing instead of
unhealthy rates. They should adopt
customer centricity by increasing
transparency and easy to understand
forms / communications including
policy and endorsements.
Suggestive Draft of India Motor
Insurance Guide
In exercise of the powers vested under
Section … of the … Act, …, the authority
stipulates the Guide for motor insurance
in India as detailed in further sections.
This guide supersedes erstwhile India
Motor tariff and related circulars issued
from time to time.
SECTION 1: General Regulations
1. Applicability
This guide is binding on all general
insurers for insuring any motor vehicle
and issuing a motor policy in India.
This guide will be effective from…
2. Classification of Vehicles
Classification of vehicle for insurance
purpose is defined in accordance with the
provisions of the Motor Vehicles Act, 1988
and Central Motor Vehicle Rules, 1989 to
avoid any ambiguity on interpretation.
2.1 Private Vehicles
Private vehicles are, which are primarily
used by the owner for his personal,
professional and business use, but
excluding use for hire or reward or
carrying business goods (other than
samples or for presentation).
2.1.1 Motor Cycle i.e. Two Wheelers
with or without side car (Non Transport
Vehicle)
2.1.2 Three Wheeler (For Personal Use)
2.1.3 Motor Car (Non Transport Vehicle)
2.1.4 Omni Bus (Non Transport Vehicle)
2.1.5 Invalid Carriage
2.2 Commercial
Any vehicle other than private vehicle is
classified as a commercial vehicle. Few
of these may not be in use for hire or
reward or carrying business goods but the
primary purpose of use is profession or
business.
2.2.1 Goods Carriage
2.2.1.1 Motor Cycle with / without side car
2.2.1.2 Light Motor Vehicle – 3 Wheeler
(GVW <=7500 Kg)
2.2.1.3 Light Motor Vehicle – Other than 3
Wheeler (GVW <=7500 Kg)
2.2.1.4 Medium Goods Vehicle (GVW
>7500 Kg and <=12000 Kg)
2.2.1.5 Heavy Goods Vehicle – Non
Articulated (GVW >12000 Kg)
2.2.1.6 Heavy Goods Vehicle – Articulated
(GVW >12000 Kg)
2.2.1.7 Tractors – Non Agricultural and
Non Articulated
2.2.1.8 Trailers – Goods carrying and non
Agricultural
2.2.2 Passenger Carrying Vehicle
2.2.2.1 Private Service Vehicle
2.2.2.1.1 Omni Bus (Transport Vehicle)
2.2.2.1.2 Medium Passenger Motor
Vehicle
2.2.2.1.3 Heavy Passenger Motor Vehicle
– Non Articulated
2.2.2.1.4 Heavy Passenger Motor Vehicle
– Articulated
2.2.2.2 Public Service Vehicle
2.2.2.2.1 Motor Cycle (Transport Vehicle)
2.2.2.2.2 Motor Cab
2.2.2.2.3 Maxi Cab – Contact Carriage
2.2.2.2.4 Maxi Cab – Stage Carriage
2.2.2.2.5 Medium Passenger Motor
Vehicle
2.2.2.2.6 Heavy Passenger Motor Vehicle
– Non Articulated
2.2.2.2.7 Heavy Passenger Motor Vehicle
– Articulated
2.2.2.3 Educational Institution Bus
2.3 Specialized Vehicles, Which are
Generally Neither for Goods Carrying Nor
Passenger Carrying and Registration of
the Vehicle is for Specific Purpose
2.3.1 Agricultural Tractor
2.3.2 Agricultural Trailer (including
agricultural implants built to be drawn by
tractor for use in agricultural field)
2.3.3 Power Tiller
2.3.4 Road Roller
2.3.5 Construction Equipment Vehicle
2.3.6 Fire Brigade Vehicle
2.3.7 Ambulance or Hearse
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2.3.8 Vehicle fitted with specialized
equipment e.g. Rig, Generator,
Compressor, Tower Wagons, Tree trimmer
etc. or similar
2.3.9 Vehicle used for specialized mobile
purpose e.g. canteen, shop, workshop,
clinic, dispensary, blood collection /
donation, library, cinema recording, media
communication etc. or similar
2.4 Trade Vehicle Used and Driven
Under a Trade Certificate (out of scope of
this research paper)
Notes:
1. IME 1 must be included in the policy
2. Class of Vehicle under which a
proposal is accepted must be shown
on the schedule
3. Insurer may use suitable warranty for
restricting the use for specific purpose
e.g. own goods
3. Proposal Form
All insurers must ensure that proposal
form is kept easy and questions are as
clear as possible. A copy of the proposal
form and / or transcript of any information
taken otherwise must be attached with the
policy.
4. Policy Form
All insurers shall use the guide policy
wordings (Annexure A) for insuring any
motor vehicle. Insurers are free to include
additional text / information, wherever
allowed to do so. Benefits, which are not
applicable, can be deleted and respective
endorsements and warranties can be
included. Company specific add-on
covers and associated endorsements and
warranties can be included at appropriate
places. Limiting / restricting any benefit /
clause are not permitted.
5. Territorial Limits
A motor policy issued within these
guidelines is valid throughout India.
Insurers can extend the territorial limits
to following countries, as per their
underwriting philosophy with or without
charging any extra premium –
a. Bangladesh
b. Bhutan
c. Nepal
d. Pakistan
e. Sri Lanka
f. Maldives
IME 2 should be used for extension.
6. Sum-Insured
Sum-insured for the vehicle, accessories
and / or bi-fuel kit under the policy shall
be mutually decided by the insurer and
insured. It must be informed to the client
as part of the quotation or computation of
premium and recorded under the policy.
Once recorded, insured or insurer cannot
change this value during currency of the
policy. However, same would be revised
as mutually agreed on every renewal of
the policy.
7. Period of Insurance
Normally policy shall be issued for one
year term, unless otherwise proposed by
the insured. In no case, a policy would be
issued for a period greater than one year
except as provided under extension and
lay-up provisions of this guide or circular
#... allowing Long Term Motor Two
Wheeler Insurance Policy. If the period is
less than one year, no refund of premium
would be made on cancellation of policy.
8. Insurance without Mandatory Legal
Liabilities Benefit
Benefit: Mandatory Legal Liabilities must
be part of a motor policy issued in India
for fulfilling the provisions of The Motor
Vehicles Act, 1988. A policy can be issued
on a vehicle without this mandatory
benefit, provided it is complying with
below provisions –
Vehicle is not required to be registered
under provisions of The Motor
Vehicle, 1988 or the vehicle is not
permitted by the concerned authorities
for general road use.
Insured gives a declaration that
vehicle shall be used only within
the stated project site / factory (or
otherwise) premises, where general
public has no general right to access.
In this case, legal liability of the
insured can be covered as a separate
benefit.
No ‘Covernote’ and / or ‘Certificate
of Insurance’ as per ‘Form-52’ and
‘Form-51’ respectively of Central
Motor Vehicle Rules, 1989 shall be
issued by the insurer.
IME 10 should be used.
9. Excess (Deductible)
Insurer may include an Excess / Franchise
in the policy as part of underwriting
of the vehicle and depending upon the
loss experience and / or moral hazard.
However, it would be obligatory for
insurer to prove that such excess was
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informed to the insured as part of quote
or prior to sourcing the insurance and is
clearly mentioned on the Policy Schedule.
This can be made applicable to any or
all groups / perils of the Benefit: Own
Damage. This must be a primary rating
criterion for the policy.
10. Risks Associated with the Hired
Vehicles
Where a passenger carrying vehicle is
given for hire under an agreement of hire
and same is driven by hirer, insurer should
use following endorsements –
IME 15 should be used to include the
indemnity to hirer
IME 16 should be used to restrict
coverage / extend exclusions or excess.
11. Personal Accident Cover for
Occupants
Cover for personal accident is mandatory
for at least one person, which would be
treated for insured. Alternatively cover can
be provided either for named occupants
or unnamed occupants. If for unnamed
occupants, the cover must be equal to
the seating capacity of the vehicle and the
mandatory cover for insured would not be
required.
IME 7 should be used.
12. Extended Legal Liability
Standard Policy covers the mandatory
legal liability as provided for in the Motor
Vehicles Act, 1988. Additionally insured
can opt for extended legal liability under
the Workmen’s Compensation Act, 1923,
The Fatal Accident’s Act, 1855 or at
Common Law for the occupants including
employees, non-fare paying passengers or
otherwise.
IME 8 should be used.
13. Third Party Property Damage
Standard Policy covers the mandatory
cover as provided for in the Motor
Vehicles Act, 1988. Additionally insured
can opt for extended cover (including
unlimited).
IME 9 should be used.
14. Towing Charges
Insurer may allow towing charges as per
agreement with the insured and must
clearly mention the same in the quote and
schedule of policy.
15. Other Endorsements as may be
Required –
For Liability to Soldier / Sailor /
Airmen – IME 11 should be used.
For Trailer/s – IME 12 should be
used.
For Reliability Trials and Rallies –
IME 13 should be used.
For Commercial Vehicle used for
Private Purpose – IME 14 should be
used.
For Overturning risk of Construction
Equipment – IME 17 should be used.
16. Warranties –
Insurer must use suitable warranties
as and when required. Few standard
warranties are included in the guide.
Insurers are free to use others depending
upon their own underwriting perception.
However, such warranties must not
restrict coverage as provided for in this
guide and guided policy wordings.
Membership of Automobile
Association – IMW 1 should be used.
Installation of Anti Theft Device –
IMW 2 should be used.
Restricted use of the vehicle to own
premises / project site – IMW 3
should be used.
Goods Carrying: Private Carriers –
IMW 4 should be used.
Good Driving / Accident / Claim
History – IMW 5 should be used.
17. Interpretation Issues
Any doubt / clarification / query /
ambiguity / difference of opinion etc.
on any provision of the guide including
annexure must be reported to The
Authority, who possess the only and
absolute rights for interpreting the issue.
SECTION 2: Endorsements
IME 1: Registration Classification of the
Vehicle
This policy has been issued considering
vehicle is registered as … In case you get
any change in its registration class and
type, coverage under the policy would
be suspended for all the benefits with
immediate effect unless same is informed
to us and we have agreed to effect the
changes in the policy. This change may
require you to pay additional premium.
IME 2: Extension of Territorial Limts
The territorial limit under the policy
is extended to include … <Name of
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Countries> with effect from … <insert
date> till…<insert date>.
However, cover under peril ‘Whilst in
transit by road, rail, air, inland-waterway,
lift, elevator’ under Group: Accident or
Transit of Benefit: Own Damage is not
applicable for such extension.
IME 3: Transfer of Vehicle
Based on the Fresh proposal form from
you and consent letter from seller (original
insured), the name of the insured in the
policy is changed and should be read as
… with effect from…
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 4: Substitution of Vehicle
Based on your request, the vehicle in the
policy is changed and substituted by the
vehicle as mentioned below –
Registra-
tion No.
Engine &
Chassis
No.
Make,
Model and
Variant
Year of
Manufac-
ture
Type of
Body
CC /
GVW
Seating
Capacity
Including
driver
Sum
Insured
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 5: Vehicle under Hypothecation,
Hire Purchase or Lease Agreement
The vehicle insured is purchased under
a hypothecation, hire purchase or lease
agreement with the person / firm /
company as described in the schedule,
who would deem to be the owner of
the vehicle for this endorsement. For
any claim made under the Benefit: Own
Damage, where settlement is being made
on total loss basis, monies would be paid
to the owner, as described above and
owner’s receipt would be a full and final
discharge in respect of such claim.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 6: Vehicle Lay-Up
As per your request, cover under the …
<insert applicable Benefit / Group / Peril>
is hereby suspended with effect from …
<insert date> till … <insert>. During this
period you would not be entitled to any
claim under subjective benefit / group /
peril.
In case, end of suspended period is not
informed by you upfront, you shall inform
the same before revoking the suspension
of registration certificate or lay-up period,
you can use by adjusting against the
premium for subsequent renewal with
us.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 7: Occupant’s Personal Accident
In case of an occupant suffering death or
disabilities as a result of an accident of
the vehicle, whilst he was travelling in the
insured vehicle (including mounting on or
dismounting from the vehicle), we will pay
such occupant a sum as specified in the
schedule read in conjunction of the scale
mentioned below –
1. Death / Permanent Total Disablement
/ Loss of Two limbs / Loss of sight of
two eyes / loss of one limb and sight
of one eye – 100%.
2. Loss of one limb / Loss of sight of one
eye – 50%.
Provide that:
1. Such death / disablement are a direct
result of such accident and occur
within 6 months of the date of such
accident.
2. Number of occupants in the vehicle at
the time of accident does not exceed
the registered seating capacity.
3. There is no reason to believe that such
accident is a result of intentional self
injury, suicide or attempted suicide,
any physical defect / infirmity of the
person concerned, such person was
under the influence of intoxicating
liquor or drug.
whichever is earlier. If you fail to do so,
no extension of period or refund would
accrue under this endorsement.
In result of this, based on your option
<select applicable option> –
Period of the Policy is extended till…
<insert end date of extended period>
A refund of premium of ` … <insert
amount of refund including service
tax> is credited to your account, which
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Conditions:
In case the cover opted for number of
occupants is lower than the seating
capacity of the vehicle as mentioned in
the registration certificate, our liability
shall arise in following manner –
If coverage is for only one
occupant – Cover would be treated
for you only.
If coverage is for named occupants
– Cover would be treated only for
named persons.
If coverage is for unnamed
occupants – This must equal to the
seating capacity and would apply
for occupants.
Occupant shall be eligible for one
compensation only under above.
Receipt given by such occupant or
occupant’s legal heir (upon death of
the occupant) would be a full and final
discharge in respect of such claim.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 8: Extended Legal Liabilities –
Occupant of the Vehicle
We will indemnify you against your legal
liabilities, not being a liability under the
Motor Vehicles Act, 1988, towards injury
/ death to any person being carried in
the vehicle (including mounting on or
dismounting from the vehicle) at the time
of accident.
Liability available under this endorsement
is limited to the Workmen’s Compensation
Act, 1923, The Fatal Accident’s Act, 1855
or at Common Law (as amended as on the
date of this endorsement), as applicable
in relation to the occupant person’s status
and relationship with you.
We will pay for any cost or expense
incurred by you with our prior and written
consent.
Provided that –
1. We will have first right of refusal
if there is another policy in effect
covering the same liability.
2. Number of persons in the vehicle is
not exceeding the registered seating
capacity.
3. Such person is being carried in the
vehicle in connection of the journey
only e.g. charterer of the goods.
4. If the occupant is your employee, you
have kept proper records for such
person employed including wages /
salaries paid
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 9: Extended Third Party Property
Damage
Cover for damage to property of any
third party is extended to the sum of ` …
<insured extended sum-insured>.
IME 10: Legal Liability of Insured Other
than Mandatory Legal Liability
We will indemnify you against your legal
common general liabilities towards injury
/ death to or damage to property of any
third party, who is not your employee, in
connection with the use of insured vehicle
within the stated project site / factory (or
otherwise) premises, where general public
has no general right to access.
This endorsement does not cover any
liability arising under the provisions of the
Motor Vehicles Act, 1988, the Workmen’s
Compensation Act, 1923 or the Fatal
Accident’s Act, 1855.
This will include any cost or expense
incurred by you with our prior and written
consent.
Provided that –
1. We will have first right of refusal
if there is another policy in effect
covering the same liability.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 11: Accident to Soldiers / Sailors /
Airmen Employed as Driver
The coverage under the policy is
extended to relieve you for your liability to
indemnify the Ministry of Defence under
their respective regulations, if the driver of
the vehicle was a Soldier / Sailor / Airmen
and was under your employment at the
time of accident.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 12: Trailer
We will indemnify you for any loss or
damage to a trailer treating it a part of the
vehicle and with the limits of sum-insured,
as described hereunder, as long as the
same was attached to and being drawn
by the insured vehicle at the time of such
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loss or damage. Coverage / Peril in scope
would apply to the trailer as applicable
for the vehicle including mandatory legal
liabilities.
Descrip-
tion of the
Trailer /
Agricultural
Implant
Registration
Number / Chas-
sis Number or
other identifica-
tion mark
Sum-
Insured
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 13: Reliability Trials or Rallies
The words ‘Reliability Trials or Rallies’
are hereby stands deleted from the
‘Limitations of use of Vehicle’, as
described under ‘Your Duties’ for the
period and event as described below –
Period: From…<Insert date> till <insert
date>
Event: …<insert name of the event> to
be held at …<insert place or route> and
organized by <insert organizer’s name>.
During the course / period of the
described event any liability (including
personal accident) towards the occupant
is not covered.
This endorsement will not cover any
liability of organizers.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 14: Use of Commercial Vehicle for
Private Purpose
The policy shall remain operative for
following benefits, if covered otherwise
and shown on your policy, whilst the
vehicle insured is being used for private
and social purpose
Benefit: Own Damage and Group
Group: Occupant’s Personal Accident
(Refer IME 7 attached)
Group: Extended Legal Liabilities –
Occupant of the Vehicle (Refer IME 8
attached)
We will also indemnify you for your legal
liabilities, not being a liability under the
Motor Vehicles Act, 1988, towards injury
/ death to any person being carried in
the vehicle (including mounting on or
dismounting from the vehicle) at the time
of accident under The Fatal Accident’s Act,
1855 or at Common Law (as amended as
on the date of this endorsement) provided
that such person is neither your employee
nor carried for a fare.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
IME 15: Indemnity to Hirer
The coverage of the policy is extended to
indemnify any hirer against loss / damage
or liability in connection with the vehicle
arising from negligence of you or any of
your employee, while the vehicle is given
on hire under an agreement provided hirer
complies with and fulfills the requirements
mentioned in the policy under clause ‘Your
Duties’.
IME 16: Hired Vehicle and Driven by
Hirer
If you enter into an agreement of hire with
a person (hereinafter called the Hirer),
where you give the vehicle to the hirer
and the same be driven by the hirer or any
other person of hirer’s choice, this policy
shall remain operative only if you fulfill
following requirements –
Hirer has provided the requisite
information in the prescribed format
with his signature.
Hirer undertakes to comply with the
requirements mentioned in the policy
under clause ‘Your Duties’.
Both of the above are provided to us
prior to start of such agreement.
In addition –
We will not be responsible for any loss
or damage from theft or conversion of
the vehicle in <whole or>* part thereof
by hirer.
Policy would be subject to an Imposed
Excess of ` … for any claim under
Benefit: Own Damage
Policy would be suspended if the
hirer uses the vehicle for carriage of
passengers for fare.
Other particulars / terms / conditions
/ warranties of the policy remain
unchanged.
May be deleted by insurer.
IME 17: Overturning Risk for
Construction Equipment Vehicle
We will not be responsible for –
Any loss or damage caused by
overturning of the vehicle, while
the vehicle is in operation and such
overturning is arisen due to use of any
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tool, plant or fixture whether forming
part of the vehicle or attached thereto.
This clause is limited to the peril
‘Accident while driven or parked’ and /
or ‘Landslide or Rockslide’.*
Any liability of whatsoever nature
beyond ‘Benefit: Mandatory Legal
Liability’.
* Insurer should delete if ‘Benefit: Own
Damage’ is not covered.
SECTION 3: Warranties
IMW 1: Membership of Recognized
Automobile Associations
Warranted that you will inform us if
you cease to be a member of declared
Automobile Association and pay us
required additional premium. If you fail
to do so; any claim would be subject to
additional Imposed Excess of `.
IMW 2: Anti Theft Device
Warranted that you will take all steps
to keep the anti theft device in working
condition at all times. If it is found that
at the time of theft of the vehicle, such
device was not in working condition;
such claim would be subject to additional
Imposed Excess of `.
IMW 3: Limited Use
Warranted that vehicle would be used
only within the informed insured’s own
premises / site. We will not be liable for
any claim arising beyond the limits of
such premises / site.
IMW 4: Private Carrier
Warranted that vehicle would only be
used to transport goods belonging to you
and your business. If it is found that the
time of loss / damage, the vehicle being
used for transport of goods other than
yours and your business, policy would be
subject to an additional Imposed Excess
of …% of the claim amount.
IMW 5: Good Driving / Accident / Claim
History
Premium for the policy has been
calculated basis your declaration –
a. That the vehicle has no accident or
claim for last … years and not more
than … accident or claim since you
purchased the same.
b. That the main driver has no accident
for last … years and not more than
… accident/s or claim/s since he/she
obtained the driving license.
Warranted that if the above information is
found to be incorrect, your claim would be
reduced by 25% of the assessed amount.
Guide Policy Wording for Motor
Insurance in India
Welcome Clause
We welcome you for choosing us
for insuring your vehicle and related
liabilities…
<Company specific information>
Please note that this is a legal contract
between you and us. It is important that
you go through this document carefully
and –
check the correctness of the details
mentioned in the schedule about you
and your vehicle
check the coverage and exclusions
offered according to what were
solicited by you and committed by us
or our authorized agent at the time of
solicitation of insurance
check the premium for its
completeness as paid by you
check the copy of the proposal
that you submitted or transcript of
information you provided over phone
/ verbal at the time of soliciting this
insurance
Having Any Query? You May Reach Us
You can reach us through any of below
modes, if you require any clarity / help
Contact your agent / broker <Agent
/ Broker Name, Code and Contact
Number>
Contact our branch office at <Policy
Issuance Office>
Call us at <Call Centre Number>
Email us at <Customer Support Email
ID>
Write to us at <Customer Support
Address>
Visit us at <Website>
What Comprises Your Legal Motor
Insurance Policy
Information given by you, in proposal
form, telephonic call, verbal or
through any other means, at the time
of soliciting this insurance.
Covernote, if any, issued by our
authorized agent / employee, that is
mentioned in the schedule of policy.
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Schedule of policy
Certificate of insurance issued in
accordance of the Motor Vehicles Act,
1988
Clauses, conditions, endorsements,
warranties as given in subsequent
pages under sub headings –
Rights and Duties
Coverage / Perils in scope
Coverage / Perils out of scope
Conditions Applicable
Claim Procedures and Governance
Endorsements & Warranties
Any further endorsement on the policy
as per your request effective ab-initio
or a later date.
Rights and Duties
Your Rights –
You have the rights
To be provided with premium charged
benefit-wise
To choose for an electronic, soft copy
or hard copy of your policy
To be explained the computation of
compensation on happening of a claim
To be explained the reasons in detail,
if company declines a claim
To approach us if you feel cheated at
any time or are not satisfied with the
product or services of the company or
find us not fulfilling our duties to your
satisfaction. Please refer the Grievance
Redressal Section for the information.
Your Duties –
You shall fulfill these duties at all times.
Non fulfillment of any or all may lead to
this contract being void or voidable on
our part resulting in to repudiation of your
claims under the policy.
Disclosures
All information provided at the
time of soliciting this insurance
or later must be complete, true
and correct to the best of your
knowledge.
Any change in the subject matter
or any other related information
must be provided to us as early
as possible and within reasonable
time.
Reasonable Care
You shall take all reasonable steps
to safeguard the vehicle from loss
or damage of any kind as if it is
uninsured.
You shall use (or allow the use of)
the vehicle on public place only
if the vehicle is in efficient and
roadworthy condition and comply
with provisions of the Motor
Vehicles Act, 1988.
In the event of any accident or
breakdown:
You shall not left the Insured
Vehicle unattended without proper
precaution being taken to prevent
any further loss or damage.
You shall not allow use of the
vehicle prior to necessary repairs
are carried out to bring it in
roadworthy condition.
Limitations of Use of Vehicle –
You shall not drive or allow
anybody to drive the vehicle
unless the person driving
is allowed to drive the class
of vehicle by the respective
authorities by way of a valid
driving license.
You shall not use the vehicle in
contravention of its registration
class, permit and fitness as
explained in Motor Vehicles Act,
1988.
You shall not use the vehicle
in connection with any of the
following activities unless you
have given us a prior notice and
we have allowed you in writing –
Organized Racing
Pace Making
Speed Testing
Reliability Trials or Rallies
Motor Trade
Our Rights –
We have the rights
To examine the vehicle or driver at any
time with prior notice.
To ask for all reasonable information
and assistance, which to our
knowledge, may impact our decision
on a claim or its quantum payable.
To arrange for a representation at any
Inquest or Fatal Injury, which may be
subject to indemnity under the policy.
To undertake the defense of
proceedings in court of law for any
alleged offence that may be subject to
indemnity under the policy.
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Our Duties –
We will provide you all clarifications
and support on policy related matters
for pressing any endorsement and / or
claim as and when required.
We will provide you clear reasoning, if
we decline your claim at any point of
time.
We will provide you full calculation of
compensation payable under a claim
Coverage / Perils in Scope
Benefit: Mandatory Legal Liabilities –
We will indemnify you for –
Your legal liabilities in respect of
death or bodily injury to a person or
damage to property of a third party
caused by or arising out of the use of
insured vehicle in a public place as
may be established under and subject
to provisions of Motor Vehicles Act,
1988 as amended on the date of
inception date of the policy
Legal liabilities as provided for under
above provision, would include
liabilities of driver of the vehicle within
the provision of the policy and / or
Motor Vehicles Act, 1988
Your costs and expenses incurred
with our prior consent
Special Provisions to this Benefit
Any occupant carried in the vehicle,
who is not a dependent upon you,
shall be eligible for indemnity
under above provisions, provided
vehicle is registered and used as
a Non-Transport vehicle and such
occupant is not an employee of you
under the provisions of Workmen’s
Compensation Act, 1923.
No provision of this policy shall affect
the rights of any person, who has the
rights to be indemnified or recover
any amount under the provisions
of the Motor Vehicles Act, 1988.
However, you shall pay us all such
sums, which we would have not liable
to pay otherwise.
If there is more than one person,
having rights for indemnity, any limit
as mentioned in the policy shall apply
to aggregate amount of indemnity of
all such persons according to priority
set by you.
Benefit: Own Damage –
If the insured vehicle (including any
accessories and bi-fuel kit as long as
the same is found fitted on the vehicle
at the time of accident and is shown on
the schedule) suffers any loss or damage
by any of the following, we will pay you
for such loss and damages, subjects to
exclusions mentioned –
Group: Fire & Allied Perils –
Fire
Explosion
Self Ignition
Lightening
Group: Accident or Transit
Accident while driven or parked
Whilst in transit by road, rail, air,
inland-waterway, lift, elevator. This
cover is not available if such transit is
for ferrying the vehicle outside India.
Group: Theft or Housebreaking
Group: Act of God Covers –
Earthquake (Includes damage by Fire
and / or shock)
Landslide or Rockslide
Flood, Inundation, Strom, Hailstorm,
Frost, Tsunami or related perils
Group: Damages by any Person or
Activity –
Malicious Activity
Riots or Strike
Terrorism
Group: Towing charges, if necessitated
and incurred subject to limits mentioned
in the schedule of policy
Group: Additional Add-On Covers –
…
…
<Include company specific add-on cover
that is applicable for damage to the
vehicle>
(Mention only those groups, which are
covered)
Benefit: Extended Liabilities or Personal
Accident –
Group: Occupant’s Personal Accident
(Refer IME 7 attached)
Group: Extended Legal Liabilities –
Occupant of the Vehicle (Refer IME 8
attached)
Group: Extended Third Party Property
Damage Cover (Refer IME 9 attached)
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Group: Legal Liability of the Insured
(Applicable for a policy issued without
Mandatory Legal Liabilities Cover as
per Rule 8.0 of the guide) (Refer IME
10 attached).
Group: Additional Add-On Cover
<Include company specific add-on cover
that is applicable for any kind of liability>
(Mention only those groups, which are
covered)
Coverage / Perils out of Scope
If we observe that you fail to fulfill
your duties at the time of occurrence
of loss or damage and / or arisen of
liability
Any Consequential loss, depreciation,
wear and tear, mechanical and / or
electrical breakdown, failures or
breakages
Loss of or damage to tyres and tubes
unless the Insured Vehicle is damaged
at the same time
Any accidental loss or damage and
/ or liability suffered whilst driver of
the vehicle is under the influence of
intoxicating liquor or drugs
Loss or Damage and / or liability
caused, sustained or incurred outside
the territorial limits as mentioned or
endorsed
Any kind of contractual liability
Any loss or damage and / or liability
directly or indirectly caused by or
contributed to by or arising from
ionizing, radiations or contamination
by radioactivity from any nuclear fuel
or from any nuclear waste from the
combustion of nuclear fuel. For the
purpose of this exception combustion
shall include any self sustaining
process of nuclear fission
Any loss or damage or liability directly
or indirectly caused by or contributed
to by or arising from nuclear weapons
material
Any loss or damage and / or liability
directly or indirectly or proximately or
remotely occasioned by, contributed
to by or traceable to or arising out of
or in connection with war, invasion,
the act of foreign enemies, hostilities
or warlike operations (whether before
or after declaration of war), civil
war, mutiny, rebellion, military or
usurped power or by any direct or
indirect consequence of any of the
said occurrences and in the event
of any claim hereunder the insured
shall prove that the accidental loss
or damage and / or liability arose
independently of and was in no way
connected with or occasioned by
or contributed to by or traceable to
any of the said occurrences or any
consequences thereof and in default
of such proof, We shall not be liable to
make any payment in respect of such
a claim.
Conditions Applicable
Territorial Limits
Policy is valid throughout India and shall
include countries, if any, included by way
of endorsement attached.
Vehicle Requisitioned by Government
In a situation of vehicle being
requisitioned by the Indian Government
(including State or Local Government)
under any legal provisions, you would
enjoy continue cover under this policy.
However, in case of any loss / damage /
arisen of any liability during the period of
such requisition, we will settle the claim
under normal circumstances and you
would require to pay us back any amount
recovered from the Government or
subrogate your rights to us for any known
or future amounts recoverable from the
Government.
Cancellation of Policy
You may cancel this policy any time
before expiry by giving written notice
and there has been no claim on the
policy, you would be eligible for a
refund of premium (No refund, if
policy was taken for a term of less
than one year) as under –
If you have another policy for
same vehicle and same sum-
insured with us – Full Premium
Paid (if other policy is incepting
earlier and is in force) less
administrative charges of ` 100/-
If you have another policy for
same vehicle and same sum-
insured with other insurer – Pr-
rata premium refund for unexpired
period less administrative charges
of ` 100/-
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If you do not have any other policy
– We will retain full premium for
mandatory legal liability cover.
For rest of the premium, refund
of premium for unexpired period
would be made at below rates (of
annual premium)
Less than 4
months
0% Less than
8 months
40%
Less than 5
months
10% Less than
9 months
50%
Less than 6
months
20% Less
than 10
months
60%
Less than 7
months
30% Less
than 11
months
70%
Less than 12 months 80%
If you sell the vehicle before
expiry and submit the other
insurance proof of the vehicle –
Pro-rata Premium Refund for the
remaining period.
If you sell the vehicle before
expiry but do not submit the other
insurance proof of the vehicle
(and do not provide NOC to new
owner) – Pro-rata Premium
Refund (after retaining premium
for mandatory legal liability cover)
for the remaining period.
We may cancel this policy any time
before expiry by giving 15 days notice
to you and you would be eligible for a
refund of premium as under –
If we cancel on grounds of any
fraudulent act, mis-representation,
mis-declaration, non-cooperation
by or from you – NIL.
For any other reason – Pro-
rata Premium Refund for the
remaining period calculated from
16th
day of the notice.
Transfer of Policy
If you sell the insured vehicle before
expiry of the policy, whether recorded
on RC or not, following provisions
would apply with immediate effect –
Policy would stand suspended
except for mandatory legal liability
cover.
If you do not want to pass on
the insurance to new owner, you
may apply for refund of premium
as per condition ‘Cancellation of
Policy’.
If you pass on the insurance to
new owner, please provide NOC
(your consent letter) to new owner
and the new owner can apply for
transfer of this insurance in his
name by submitting following
documents / information and
required premium –
Your consent letter
Original Certificate of Insurance
Fresh proposal form duly filled in
and signed by the new owner
Inspection of the vehicle, if
required by us
Deposit of additional premium,
if any required by us plus ` 50/-
towards administrative charges.
Notes –
If this application is not submitted
within 14 days from date of purchase,
policy would stand suspended except
for mandatory legal liability cover
If this transfer of policy is required
because of death of the owner and
such transfer is to be effected in the
name of your legal heir / next kin,
subject to following provisions –
Legal heir / next kin must apply
for transfer in his / her name with
following documents / information
within 90 days, but before expiry
of the policy, of death of owner –
Owner’s death certificate
Legal Heir Certificate or
Transferred RC with relationship
proof
Else policy would stand suspended
except mandatory legal liability cover
from the 91st
day (if policy not expired
earlier) till expiry of policy.
Insured / new owner would not be
eligible for any extension of policy
period for the number of days
policy is kept under suspension.
Substitution of Vehicle
If you purchase a new vehicle and
wish to substitute the new vehicle
under the policy , you may request
for the same with following document
/ information and by depositing the
required premium –
Proof of insurance for the Insured
Vehicle
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Fresh proposal form in respect of
new vehicle
Premium, as may be required by
us. This would be the difference of
premium required for new vehicle
less premium paid calculated on
pro-rata basis for the remaining
period of insurance.
Extension of Policy Period
Policy Period can be extended by us
upon your written request to arrive
at a common expiry date convenient
to you provided you pay us pro-rata
premium for such extended period
and your consent that you shall renew
the insurance with us for full 12
months upon expiry of such extended
period, failing which you shall
pay us the difference between the
Short Period Rates and the pro-rata
premium then paid.
Vehicle Laid-Up
If you wish to stop usage of the
vehicle for certain period and lay-
up the vehicle in garage with or
without surrendering the Registration
Certificate to respective authorities,
you shall be eligible for following
benefits –
If such lay-up is with surrender of
Registration Certificate –
You may get the policy period
extended by the lay-up period.
You may opt for pro-rata credit of
premium for the lay-up period.
If such lay-up is without surrender
of Registration Certificate –
You may opt for surrendering the
coverage (one or more groups)
under the ‘Benefit: Own Damage’
and / or ‘Benefit: Extended
Liabilities or Personal Accidents’
and shall be entitle for pro-rata
credit of premium for respective
benefits for the lay-up period.
Notes:
Lay-up must not be as a result of any
event giving rise to a claim under the
policy and lay-up period must not be
less than 60 consecutive days.
This can be opted only once during
the currency of the policy including
any extended period.
The credit of premium can be utilized
against the renewal premium of the
policy. This cannot be availed in cash
in any circumstances except where
vehicle is sold during the currency of
such lay-up period.
Claims Procedures and
Governance
Notification of Claim
Upon occurrence of any incidence
that may give rise to a claim under the
policy:
You shall report to us at the
earliest and within reasonable time
through any recorded means of
communication like phone call, email,
letter, online etc.
You shall report the matter to police, if
there is a cognizable offence like third
party death / injury / damage, theft or
malicious damage etc. A copy of the
report must be provided to us. Report
to police is not mandatory for collision
with other motor vehicle without any
third party death / injury.
You shall provide all such information
and assistance as may be required
by us or by our authorized surveyor,
which may affect our decision on
claim or quantum of claim.
You shall take due care and preserve
the damaged property for our
inspection as also to avoid any further
damage or loss.
In case the incidence involves any
form of legal process:
You shall immediately send us
every written notice or information
of any verbal notice of a claim.
You shall immediately send us
any letter, claim, writ, summons,
or other legal process received by
you.
You shall permit us to take over
the control and conduct of the
defence, pursuit or settlement
of any claim and provide us or
our representatives with such
cooperation and assistance as
may be required for that purpose.
You shall not, without our prior
written consent, incur any costs,
admit liability for or attempt to
settle, make any admission, offer
any payment or otherwise assume
any contractual obligation with
respect to any legal action or
threat of legal action.
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Documents Required
Usually following documents are
required for a claim. However,
depending on the situation and merits,
we may ask for more information /
documents –
Claim under Benefit: Own Damage
Claim Form duly filled in
Self attested copy of Vehicle
Registration Certificate and
original for verification
Self attested copy of driver’s
Driving License and original for
verification
Self attested copy of Vehicle
Permit and Fitness and original for
verification
Copy of Police First Information
Report, if any
Claim under Benefit: Third Party
In addition to above documents
Copy of the plaint received
Copy of Police First Information
Report.
Detailed explanation about the
situation in which accident / loss
happened.
Basis of Settlement for a Claim
All claims would be settled only in
India Rupees.
It would be our right to decide on
whether a claim is to be settled as
a total loss or partial loss.
In case of a total loss (including
theft), you would be eligible for
payment of Sum-Insured as
mentioned in the schedule –
In full after deducting excess.
In which case the wreck of the
vehicle including its registration
rights would be subrogated to us.
After deducting excess and
salvage value of the wreck. In
which case you would retain the
wreck, however, this policy will be
deemed to be cancelled from next
day of the loss occurring event.
In case of a partial loss (including
theft of part of the vehicle) –
We would have rights to decide
on reinstate, replace, repair or
refurbish a particular part or
accessory.
If any part is replaced with new,
depreciation at below rates would
be deducted.
Claim would be settled only
after all allowed repairs or
replacements are carried out
unless we decide to settle the
claim for cash in which case you
would be eligible to retain salvage
but policy will be deemed to be
cancelled from next day of the
loss occurring event.
In case there is more than one
insurance on the vehicle covering
the peril occurred, we will pay
only a rateable proportion of the
admissible claim.
Deductions from the Claim Amount
Depreciation
We will deduct the depreciation at
following rates in respect of parts
replaced
Main material, the respective part is made of Rates
Rubber / Nylon / Plastic, Tyres, Tubes, Batteries, Airbags 50%
Fibre Glass 30%
Glass 0%
Painting: Material Cost of the Painting Charges
(In case Material Cost is not separately mentioned in Painting Bill, 25%
of total Painting Charges would be considered as material)
50%
All other, including wooden), as per the following schedule based on
age of the vehicle as computed from the date of purchase or date of
registration, whichever is earlier:
Not exceeding 6 months 0%
Exceeding 6 months but not exceeding 1 year 5%
Exceeding 1 year but not exceeding 2 years 10%
Exceeding 2 years but not exceeding 3 years 15%
Exceeding 3 years but not exceeding 4 years 25%
Exceeding 4 years but not exceeding 5 years 35%
Exceeding 5 years but not exceeding 10 years 40%
Exceeding 10 years 50%
MOTOR INSURANCE
103JANUARY-MARCH 2015
THE JOURNAL OF INSURANCE INSTITUTE OF INDIA
Excess / Franchise –
A Sum of amounts as mentioned in
the schedule of policy under heading
excess. Excess may be applicable to
all benefits, any particular benefit or
any particular peril, as mentioned in
the schedule of policy.
Excess may additionally be applicable
as mentioned in any warranty
Franchise, if any mentioned on the
schedule, is the amount up to which
no claim is payable. Claim, greater
than this amount, are paid in full.
Special Deductions for Commercial
or Transport Vehicles –
A vehicle covered under any sub
classification of section 2.2.2
(excluding classes 2.2.2.1.1, 2.2.2.2.1,
2.2.2.2.2, 2.2.2.2.3 & 2.2.2.2.4) shall
be subject to special exclusion of
loss of or damage to lights, tyres,
tubes, mudguards, bonnet side
parts, bumpers and paints. In case of
settlement of claim as partial loss, no
amount would be paid towards repair
/ replacement / refurbishment of these
parts.
<This special deduction clause is not
compulsory and may be omitted by
the insurer>
Grievance Redressal Arrangements
If you feel that you are cheated at any
time or are not satisfied with the product
or services of the company or find us not
fulfilling our duties to your satisfaction,
please approach any of the below
authorities for redressal –
Your agent whom you solicit this
insurance or who has been assigned
by the company for serving you
Company’s Branch or Customer
Service Officer through phone call,
email, online, letter or in person as
given under Reach Us on Welcome
Clause
Company’s Grievance Redressal /
Escalation System
Regulator, IRDA, through IGMS
Insurance Ombudsman of your Area
Consumer Grievance Redressal
Forums, set up under the Consumer
Protection Act, 1986
- Any other means as provided by
various Ministries of Indian / State
Government for lodging a complaint
or any other empowered judiciary
Endorsements & Warranties
<Insert as required>
General Information
Your Premium
Premium computation for your vehicle is
dependent upon various factors. These
may vary insurer to insurer. You may ask
for details of these factors and various
components of the premium benefit-wise.
It is important that you provide complete
and true information against questions
/ points / columns in the proposal form
or otherwise. Any incorrect information
provided by you before or after obtaining
this insurance may lead to this contract
being voidable on our option.
Your premium is calculated on a particular
excess. You may reduce your premium
by opting for an extra excess. The higher
the excess you choose, the lower the
premium you pay.
Renewal of Your Policy
It is mandatory to carry a valid policy
of insurance all the time as per the
provisions of Motor Vehicles Act, 1988. It
is important that you renew the insurance
before expiry of this policy. Though we
may send you reminder before policy
renewal date using various means e.g.
letter, email, sms, phone etc. yet you shall
set your own reminders for the renewal
date to ensure timely renewal. TJ
References
Tariff Advisory Committee (2002) India Motor Tariff.
Insurance Regulatory and Development Authority
(various dates) Circulars related to Motor Insurance /
India Motor Tariff from www.irda.gov.in.
Peeyush Agarwal (2013). Motor Insurance in India
– New Vistas. Asia Insurance Review. January 2013
P.58-59. http://www.asiainsurancereview.com/
Magazine/ReadMagazineArticle?aid=33226.
MOTOR INSURANCE

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Paper - Motor Insurance - Tariff, Detariff and Beyond... (India)

  • 1. 86 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Abstract India Motor Tariff was abolished in 2007, but its provisions and wordings were kept in force. Unfortunately broader market still functions under tariff mindset. Rates are quoted as Tariff-x% and interpretation of tariff is used for own benefit. With the new age marketing channels, insured is often trapped in mis-selling. Unfriendly and complex legal languages of policy add to insured’s nuisance. Author observes number of anomalies in provisions of the tariff. Besides critically Peeyush Agarwal Head – Operations and Business Project Lead (Legacy System Transformation) Tata AIG General Insurance Company Limited, 225, Vasundhara, Thakur Village, Kandivali East, Mumbai - 400101. peeyagarwal@gmail.com Motor Insurance – Tariff, Detariff and Beyond… analyzing such provisions, research paper suggests alternate options in detail. For internal control of the industry, post taking the tariff off, suggestive guide regulations and insured friendly policy wording is annexed. Paper suggests simple provisions, merging of similar endorsements, transparent quoting and use of simple warranties than complex endorsements. Simplification is the need of the hour. Residual tariff should be taken off and industry should develop on demand & supply and insurer’s perception of risk. MOTOR INSURANCE
  • 2. 87JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Keywords Motor Insurance, India Motor Tariff, Simplifying Insurance, Beyond Tariff, Customer Friendly Policy Wording Motor Insurance is risky, long tailed, loss prone etc. are various phrases commonly used in non-life insurance parlance. Yet it remains the largest contributor making it difficult for any general insurer to survive without underwriting motor business. In India as well, motor historically constitute around 45% of gross premium (Graph 1). Graph 1: Segment-wise share in Gross Direct Premium in India (2007 – 2013) Motor Vehicles are highly regulated including liabilities arising out of use of the vehicle. So is its insurance. Motor insurance was put under tariff in 1970 after TAC came into existence. Tariff saw various revisions with changing times. Finally effective 1st January 2007, Tariff was abolished keeping the policy terms intact and rates regulated under File and Use Guidelines. Third party premiums were kept under control. Since then industry has come a long way yet not able to come out of tariff mindset. Tariff rates somehow became a benchmark akin to MRP and discounts offered on these as if a sale is going on. Add-on products allowed effective 1st January 2009 and lot of value added for the insured. Few complexities are noted in tariff leaving options for companies to interpret differently. The judiciary also would give benefit of doubt to insured that might arise because of ambiguity, complexity or fine print in regulations / wordings. Difficult to understand legal kind of language tend the client not to read the document and rely on verbal information thus falling under the trap of misselling. Time has come, when Market should step further with more reforms and simpler products and wordings. Legal language should be replaced with common man friendly language. Tariff should be completely removed and market should be left free to the extent feasible. Similar are the recommendations of recent working group on revision of File and Use Guidelines. Complexities of Tariff 1. There are 3 broad categories – Private Car, Two Wheeler and Commercial Vehicles. Commercial Vehicles are sub-divided on their class and usage. This classification doesn’t run neck to neck with definitions of law and leaves subjectivity. E.g. a private car type vehicle (Omni bus), running as private service vehicle (transport vehicle but not for hire or reward), leaves scope to be covered under private car or commercial vehicle. The ambiguity about classification of dumper / tipper / semi-trailer as miscellaneous or goods carrying has been a matter of debate for long. There are no differences according to actual usage within the categories e.g. stage carriage / contact carriage / educational institution bus etc., where usage and risk exposures are clearly different. 2. There is one special provision related to trailers, which is really difficult to adhere to. Tractor and Trailer can be covered in a single policy or separately. But trailer tariff stipulates that proposer need to specify the count of trailer he wish to attach with the tractor. How would he decide upfront? Depending upon need number of trailers are attached. If both are covered in same policy, can he not attach the same trailer with any other tractor? 3. There are 4 types of policy formats – Liability Only and Package Policies for Private Car, Two Wheeler and Commercial Vehicle. Referring Table 1, we see, there is hardly any difference that necessitates three different formats. For third party risks, mandatory legal risk is to be covered. For damage to vehicle, any vehicle is exposed to same risks and perils. There may be difference in scale of hazard, probability of occurrence of peril and resultant loss severities. 4. There are 49 General Regulations and many of these are related to rating. Rates are deregulated and almost all insurers have inbuilt most of them in their base pricing. Other important aspect is with regard to abolition of tariff. Would any of its regulation that is not part of proposal or policy be legally binding on the insured? MOTOR INSURANCE 50 45 40 35 30 25 20 15 10 5 0 42.95 45.59 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 Source: IRDA Annual Reports Financial Year Graph 1 Fire Marine Motor Health Others 43.94 43.46 42.7 45.84 47.05 Segment-wise Share in GDP
  • 3. 88 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Existing Deductible limits were set long ago. There are upward changes effected recently but for private car and two wheelers only. Main purpose of excess is to avoid high frequency of low severity claims. Insured gains through reduced premium and also hassle of claiming, whatever minimal it may be. Insurer saves huge cost of servicing claims, which at times may be more than claim amount. It should be left open for insured and insurer as a pricing parameter. Innovations like franchise and differentiated deductible for different perils should be explored. E.g. theft prone vehicles may have higher deductible for peril ‘theft’ to force insured taking better security measures. Special endorsements or warranties may have higher deductibles, instead of repudiating full claim, if insured is unable to fulfill requirement. This would not only enrich the data base for further in depth actuarial analysis but also improve the obligations from insured side. 5. Good driving history is primarily a rating consideration. No reasons that person claiming once or thrice enjoy same benefit in rates. No Claim Bonus provisions of the tariff are complex and raise lot of confusions. Some provisions follows the insured e.g. substitution, and others the vehicle e.g. fleet. Sometimes we may get benefit without being eligible like conversion from restricted to package without ascertaining any loss by accidental external means. Sometimes we may lose the NCB for technical reasons only like transfer of vehicle from employee to employer with user remaining same. NCB on declaration basis is another provision, which is abused like anything. No doubt NCB is one of the strongest features, however in post de-tariff era, this should follow more logical and broader relation between insured and vehicle. Ideally this should be left for insurers as one of the important rating factors. Many countries follow it differently. Instead of fixed NCB, a claim history certificate is issued by the insurer. This certificate is submitted to the insurer and evaluated for rating by underwriters. For leakage on declaration basis, Insurance Information Bureau of India has taken number of steps. But lag in upload of data on IIB site has impacted the desired results. Insurers must come together and leverage IT platforms for real time confirmations of claim status through Web-service. 6. There should not be any justification for difference in cover offered like occupants under standalone Liability Policy and Package Policy without having difference in premium. Regulating rates for mandatory Third Party Cover are understandable but not extra covers like personal accident, wider legal liability etc. For sure, we can argue that it is only the mandatory base liability cover, which affects mass and not extra benefits. It would be of interest to discuss few such extra benefits. Under Personal Accident (PA), all occupants, whether it is insured self or paid driver, family / friend, employee or any other human being, have same exposure of accidental death / injury, yet there are different clauses / endorsements in the tariff with similar cover. Result is insured end up paying for more persons than the number of occupants that can be present in the vehicle at any point of time. Example – one has to pay for owner driver, paid driver and 5 (seating capacity) unnamed passengers i.e. for total 7 if he wishes to cover all eventualities. Secondly, if person has more than one vehicle he ends up paying for self on all vehicles, where he can be present in maximum one vehicle at a time. Under Wider Legal Liability, there is different coverage under different sections for various types of classes / occupants. Most of these are available at ` 50/- per capita and covers liability under Workmen’s Compensation Act, Fatal Accidents Act & Common Law. Major difference is availability of liability under WC Act to persons employed in relation to vehicle. Cover is available with first obligation of payment under WC policy, which means premium remain same irrespective of one has a WC policy or not. Like PA, one has to pay for more than seating capacity e.g. paid driver and employees are covered under endorsement 28 & 29. Under 28, payment for 1 (driver) and under 29, for 5 (including driver) thus paying for 6. Another complex provision under MOTOR INSURANCE
  • 4. 89JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA two wheeler tariff is that premium rate is ` 50/- per employee under endorsement 28 but ` 60/- under endorsement 29, whereas risk is wider under endorsement 28. Same situation is with endorsement 37 / 38 & 39. There is no noticeable difference in endorsement 28 & 40. It would be pertinent to free at least extra covers. Let proposer pay for the cost of actual risk. Similar endorsements should be clubbed to form single endorsement. On par with own damage section, value added add- on covers should be allowed under Liability section as well. Few examples may be PA for higher amounts, unlimited third party property damage, easy re-imbursement of medical expenses, re-imbursement of counsel’s fee and other legal charges for defending criminal case / bail associated with covered accident etc. Even process should be decided, obviously with legal standing, to support easy and hassle free out of court settlements for liability. 7. Tariff carried wordings for 54 different endorsements (excluding ones related to Motor Trade Tariff). These require restructuring and including only few in guide. Rating related to be removed and similar ones to be clubbed. Even financiers’ interest related IMT # 5, 6 and 7 can also be combined, at least 5 and 7. The declaration / representations by insured in proposal form would remain important under basic insurance principle of utmost good faith. 8. There are at least 17 different limitation clauses in the tariff. Mostly they are similar with only minor differences. Even these are not proved sufficient to curb wrong classification of vehicles like dumper. With only policy format, as suggested above, there should be only one limitation and or driver clause. This should restrict usage as per registration class and permit of the vehicle and may cover other specialized usage like racing etc. 9. A clause inserted as warranty is easier to understand and follow than a full fledged endorsement. As such some endorsements can be converted into a warranty. These may further be tagged with specific clauses of higher deductible, if not fulfilled. Old saying is ‘The Only Thing That Is Constant Is Change.’ Similarly Table 1 – Differences in Policy Wordings (other than Cosmetic Differences) Parameter Liability Only Private Car Two Wheeler Commercial Vehicle Towing Charges NA 1500/- 300/- 750/-, 1500/- or 2500/- depending upon class Insured’s Authority for Repair NA 500/- 150/- 500/- Deductible NA 1000/- or 2000/- 100/- 500/- to 2000/- or above depending upon class Exclusions (only additional or differences) - Theft of Accessories - Theft of Accessories - Overloading IDV - Mention of Side Car Sections - One more Section covering Towing Disabled Vehicle - Rule 129, 131, 132, 133 are reproduced from Central MV Rules Conditions One extra condition about relinquishing of company after paying to the insured Section II – Liabilities to Third Parties Differences are observed, whereas this intend to cover liability as enumerated in MV Act Note – Limits under 1st three items were set way back in 2002 (minor revision in deductible for private car and two wheeler recently). Cost since then has risen multifold. All these items should be left to insurers and should be driven by rating for better control. MOTOR INSURANCE
  • 5. 90 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA achieving a perfect state is only theory. Innovations are there because scope of improvement and betterment is there. Industry should come out of tariff mentality and should differentiate on products and servicing instead of unhealthy rates. They should adopt customer centricity by increasing transparency and easy to understand forms / communications including policy and endorsements. Suggestive Draft of India Motor Insurance Guide In exercise of the powers vested under Section … of the … Act, …, the authority stipulates the Guide for motor insurance in India as detailed in further sections. This guide supersedes erstwhile India Motor tariff and related circulars issued from time to time. SECTION 1: General Regulations 1. Applicability This guide is binding on all general insurers for insuring any motor vehicle and issuing a motor policy in India. This guide will be effective from… 2. Classification of Vehicles Classification of vehicle for insurance purpose is defined in accordance with the provisions of the Motor Vehicles Act, 1988 and Central Motor Vehicle Rules, 1989 to avoid any ambiguity on interpretation. 2.1 Private Vehicles Private vehicles are, which are primarily used by the owner for his personal, professional and business use, but excluding use for hire or reward or carrying business goods (other than samples or for presentation). 2.1.1 Motor Cycle i.e. Two Wheelers with or without side car (Non Transport Vehicle) 2.1.2 Three Wheeler (For Personal Use) 2.1.3 Motor Car (Non Transport Vehicle) 2.1.4 Omni Bus (Non Transport Vehicle) 2.1.5 Invalid Carriage 2.2 Commercial Any vehicle other than private vehicle is classified as a commercial vehicle. Few of these may not be in use for hire or reward or carrying business goods but the primary purpose of use is profession or business. 2.2.1 Goods Carriage 2.2.1.1 Motor Cycle with / without side car 2.2.1.2 Light Motor Vehicle – 3 Wheeler (GVW <=7500 Kg) 2.2.1.3 Light Motor Vehicle – Other than 3 Wheeler (GVW <=7500 Kg) 2.2.1.4 Medium Goods Vehicle (GVW >7500 Kg and <=12000 Kg) 2.2.1.5 Heavy Goods Vehicle – Non Articulated (GVW >12000 Kg) 2.2.1.6 Heavy Goods Vehicle – Articulated (GVW >12000 Kg) 2.2.1.7 Tractors – Non Agricultural and Non Articulated 2.2.1.8 Trailers – Goods carrying and non Agricultural 2.2.2 Passenger Carrying Vehicle 2.2.2.1 Private Service Vehicle 2.2.2.1.1 Omni Bus (Transport Vehicle) 2.2.2.1.2 Medium Passenger Motor Vehicle 2.2.2.1.3 Heavy Passenger Motor Vehicle – Non Articulated 2.2.2.1.4 Heavy Passenger Motor Vehicle – Articulated 2.2.2.2 Public Service Vehicle 2.2.2.2.1 Motor Cycle (Transport Vehicle) 2.2.2.2.2 Motor Cab 2.2.2.2.3 Maxi Cab – Contact Carriage 2.2.2.2.4 Maxi Cab – Stage Carriage 2.2.2.2.5 Medium Passenger Motor Vehicle 2.2.2.2.6 Heavy Passenger Motor Vehicle – Non Articulated 2.2.2.2.7 Heavy Passenger Motor Vehicle – Articulated 2.2.2.3 Educational Institution Bus 2.3 Specialized Vehicles, Which are Generally Neither for Goods Carrying Nor Passenger Carrying and Registration of the Vehicle is for Specific Purpose 2.3.1 Agricultural Tractor 2.3.2 Agricultural Trailer (including agricultural implants built to be drawn by tractor for use in agricultural field) 2.3.3 Power Tiller 2.3.4 Road Roller 2.3.5 Construction Equipment Vehicle 2.3.6 Fire Brigade Vehicle 2.3.7 Ambulance or Hearse MOTOR INSURANCE
  • 6. 91JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA 2.3.8 Vehicle fitted with specialized equipment e.g. Rig, Generator, Compressor, Tower Wagons, Tree trimmer etc. or similar 2.3.9 Vehicle used for specialized mobile purpose e.g. canteen, shop, workshop, clinic, dispensary, blood collection / donation, library, cinema recording, media communication etc. or similar 2.4 Trade Vehicle Used and Driven Under a Trade Certificate (out of scope of this research paper) Notes: 1. IME 1 must be included in the policy 2. Class of Vehicle under which a proposal is accepted must be shown on the schedule 3. Insurer may use suitable warranty for restricting the use for specific purpose e.g. own goods 3. Proposal Form All insurers must ensure that proposal form is kept easy and questions are as clear as possible. A copy of the proposal form and / or transcript of any information taken otherwise must be attached with the policy. 4. Policy Form All insurers shall use the guide policy wordings (Annexure A) for insuring any motor vehicle. Insurers are free to include additional text / information, wherever allowed to do so. Benefits, which are not applicable, can be deleted and respective endorsements and warranties can be included. Company specific add-on covers and associated endorsements and warranties can be included at appropriate places. Limiting / restricting any benefit / clause are not permitted. 5. Territorial Limits A motor policy issued within these guidelines is valid throughout India. Insurers can extend the territorial limits to following countries, as per their underwriting philosophy with or without charging any extra premium – a. Bangladesh b. Bhutan c. Nepal d. Pakistan e. Sri Lanka f. Maldives IME 2 should be used for extension. 6. Sum-Insured Sum-insured for the vehicle, accessories and / or bi-fuel kit under the policy shall be mutually decided by the insurer and insured. It must be informed to the client as part of the quotation or computation of premium and recorded under the policy. Once recorded, insured or insurer cannot change this value during currency of the policy. However, same would be revised as mutually agreed on every renewal of the policy. 7. Period of Insurance Normally policy shall be issued for one year term, unless otherwise proposed by the insured. In no case, a policy would be issued for a period greater than one year except as provided under extension and lay-up provisions of this guide or circular #... allowing Long Term Motor Two Wheeler Insurance Policy. If the period is less than one year, no refund of premium would be made on cancellation of policy. 8. Insurance without Mandatory Legal Liabilities Benefit Benefit: Mandatory Legal Liabilities must be part of a motor policy issued in India for fulfilling the provisions of The Motor Vehicles Act, 1988. A policy can be issued on a vehicle without this mandatory benefit, provided it is complying with below provisions – Vehicle is not required to be registered under provisions of The Motor Vehicle, 1988 or the vehicle is not permitted by the concerned authorities for general road use. Insured gives a declaration that vehicle shall be used only within the stated project site / factory (or otherwise) premises, where general public has no general right to access. In this case, legal liability of the insured can be covered as a separate benefit. No ‘Covernote’ and / or ‘Certificate of Insurance’ as per ‘Form-52’ and ‘Form-51’ respectively of Central Motor Vehicle Rules, 1989 shall be issued by the insurer. IME 10 should be used. 9. Excess (Deductible) Insurer may include an Excess / Franchise in the policy as part of underwriting of the vehicle and depending upon the loss experience and / or moral hazard. However, it would be obligatory for insurer to prove that such excess was MOTOR INSURANCE
  • 7. 92 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA informed to the insured as part of quote or prior to sourcing the insurance and is clearly mentioned on the Policy Schedule. This can be made applicable to any or all groups / perils of the Benefit: Own Damage. This must be a primary rating criterion for the policy. 10. Risks Associated with the Hired Vehicles Where a passenger carrying vehicle is given for hire under an agreement of hire and same is driven by hirer, insurer should use following endorsements – IME 15 should be used to include the indemnity to hirer IME 16 should be used to restrict coverage / extend exclusions or excess. 11. Personal Accident Cover for Occupants Cover for personal accident is mandatory for at least one person, which would be treated for insured. Alternatively cover can be provided either for named occupants or unnamed occupants. If for unnamed occupants, the cover must be equal to the seating capacity of the vehicle and the mandatory cover for insured would not be required. IME 7 should be used. 12. Extended Legal Liability Standard Policy covers the mandatory legal liability as provided for in the Motor Vehicles Act, 1988. Additionally insured can opt for extended legal liability under the Workmen’s Compensation Act, 1923, The Fatal Accident’s Act, 1855 or at Common Law for the occupants including employees, non-fare paying passengers or otherwise. IME 8 should be used. 13. Third Party Property Damage Standard Policy covers the mandatory cover as provided for in the Motor Vehicles Act, 1988. Additionally insured can opt for extended cover (including unlimited). IME 9 should be used. 14. Towing Charges Insurer may allow towing charges as per agreement with the insured and must clearly mention the same in the quote and schedule of policy. 15. Other Endorsements as may be Required – For Liability to Soldier / Sailor / Airmen – IME 11 should be used. For Trailer/s – IME 12 should be used. For Reliability Trials and Rallies – IME 13 should be used. For Commercial Vehicle used for Private Purpose – IME 14 should be used. For Overturning risk of Construction Equipment – IME 17 should be used. 16. Warranties – Insurer must use suitable warranties as and when required. Few standard warranties are included in the guide. Insurers are free to use others depending upon their own underwriting perception. However, such warranties must not restrict coverage as provided for in this guide and guided policy wordings. Membership of Automobile Association – IMW 1 should be used. Installation of Anti Theft Device – IMW 2 should be used. Restricted use of the vehicle to own premises / project site – IMW 3 should be used. Goods Carrying: Private Carriers – IMW 4 should be used. Good Driving / Accident / Claim History – IMW 5 should be used. 17. Interpretation Issues Any doubt / clarification / query / ambiguity / difference of opinion etc. on any provision of the guide including annexure must be reported to The Authority, who possess the only and absolute rights for interpreting the issue. SECTION 2: Endorsements IME 1: Registration Classification of the Vehicle This policy has been issued considering vehicle is registered as … In case you get any change in its registration class and type, coverage under the policy would be suspended for all the benefits with immediate effect unless same is informed to us and we have agreed to effect the changes in the policy. This change may require you to pay additional premium. IME 2: Extension of Territorial Limts The territorial limit under the policy is extended to include … <Name of MOTOR INSURANCE
  • 8. 93JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Countries> with effect from … <insert date> till…<insert date>. However, cover under peril ‘Whilst in transit by road, rail, air, inland-waterway, lift, elevator’ under Group: Accident or Transit of Benefit: Own Damage is not applicable for such extension. IME 3: Transfer of Vehicle Based on the Fresh proposal form from you and consent letter from seller (original insured), the name of the insured in the policy is changed and should be read as … with effect from… Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 4: Substitution of Vehicle Based on your request, the vehicle in the policy is changed and substituted by the vehicle as mentioned below – Registra- tion No. Engine & Chassis No. Make, Model and Variant Year of Manufac- ture Type of Body CC / GVW Seating Capacity Including driver Sum Insured Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 5: Vehicle under Hypothecation, Hire Purchase or Lease Agreement The vehicle insured is purchased under a hypothecation, hire purchase or lease agreement with the person / firm / company as described in the schedule, who would deem to be the owner of the vehicle for this endorsement. For any claim made under the Benefit: Own Damage, where settlement is being made on total loss basis, monies would be paid to the owner, as described above and owner’s receipt would be a full and final discharge in respect of such claim. Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 6: Vehicle Lay-Up As per your request, cover under the … <insert applicable Benefit / Group / Peril> is hereby suspended with effect from … <insert date> till … <insert>. During this period you would not be entitled to any claim under subjective benefit / group / peril. In case, end of suspended period is not informed by you upfront, you shall inform the same before revoking the suspension of registration certificate or lay-up period, you can use by adjusting against the premium for subsequent renewal with us. Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 7: Occupant’s Personal Accident In case of an occupant suffering death or disabilities as a result of an accident of the vehicle, whilst he was travelling in the insured vehicle (including mounting on or dismounting from the vehicle), we will pay such occupant a sum as specified in the schedule read in conjunction of the scale mentioned below – 1. Death / Permanent Total Disablement / Loss of Two limbs / Loss of sight of two eyes / loss of one limb and sight of one eye – 100%. 2. Loss of one limb / Loss of sight of one eye – 50%. Provide that: 1. Such death / disablement are a direct result of such accident and occur within 6 months of the date of such accident. 2. Number of occupants in the vehicle at the time of accident does not exceed the registered seating capacity. 3. There is no reason to believe that such accident is a result of intentional self injury, suicide or attempted suicide, any physical defect / infirmity of the person concerned, such person was under the influence of intoxicating liquor or drug. whichever is earlier. If you fail to do so, no extension of period or refund would accrue under this endorsement. In result of this, based on your option <select applicable option> – Period of the Policy is extended till… <insert end date of extended period> A refund of premium of ` … <insert amount of refund including service tax> is credited to your account, which MOTOR INSURANCE
  • 9. 94 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Conditions: In case the cover opted for number of occupants is lower than the seating capacity of the vehicle as mentioned in the registration certificate, our liability shall arise in following manner – If coverage is for only one occupant – Cover would be treated for you only. If coverage is for named occupants – Cover would be treated only for named persons. If coverage is for unnamed occupants – This must equal to the seating capacity and would apply for occupants. Occupant shall be eligible for one compensation only under above. Receipt given by such occupant or occupant’s legal heir (upon death of the occupant) would be a full and final discharge in respect of such claim. Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 8: Extended Legal Liabilities – Occupant of the Vehicle We will indemnify you against your legal liabilities, not being a liability under the Motor Vehicles Act, 1988, towards injury / death to any person being carried in the vehicle (including mounting on or dismounting from the vehicle) at the time of accident. Liability available under this endorsement is limited to the Workmen’s Compensation Act, 1923, The Fatal Accident’s Act, 1855 or at Common Law (as amended as on the date of this endorsement), as applicable in relation to the occupant person’s status and relationship with you. We will pay for any cost or expense incurred by you with our prior and written consent. Provided that – 1. We will have first right of refusal if there is another policy in effect covering the same liability. 2. Number of persons in the vehicle is not exceeding the registered seating capacity. 3. Such person is being carried in the vehicle in connection of the journey only e.g. charterer of the goods. 4. If the occupant is your employee, you have kept proper records for such person employed including wages / salaries paid Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 9: Extended Third Party Property Damage Cover for damage to property of any third party is extended to the sum of ` … <insured extended sum-insured>. IME 10: Legal Liability of Insured Other than Mandatory Legal Liability We will indemnify you against your legal common general liabilities towards injury / death to or damage to property of any third party, who is not your employee, in connection with the use of insured vehicle within the stated project site / factory (or otherwise) premises, where general public has no general right to access. This endorsement does not cover any liability arising under the provisions of the Motor Vehicles Act, 1988, the Workmen’s Compensation Act, 1923 or the Fatal Accident’s Act, 1855. This will include any cost or expense incurred by you with our prior and written consent. Provided that – 1. We will have first right of refusal if there is another policy in effect covering the same liability. Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 11: Accident to Soldiers / Sailors / Airmen Employed as Driver The coverage under the policy is extended to relieve you for your liability to indemnify the Ministry of Defence under their respective regulations, if the driver of the vehicle was a Soldier / Sailor / Airmen and was under your employment at the time of accident. Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 12: Trailer We will indemnify you for any loss or damage to a trailer treating it a part of the vehicle and with the limits of sum-insured, as described hereunder, as long as the same was attached to and being drawn by the insured vehicle at the time of such MOTOR INSURANCE
  • 10. 95JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA loss or damage. Coverage / Peril in scope would apply to the trailer as applicable for the vehicle including mandatory legal liabilities. Descrip- tion of the Trailer / Agricultural Implant Registration Number / Chas- sis Number or other identifica- tion mark Sum- Insured Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 13: Reliability Trials or Rallies The words ‘Reliability Trials or Rallies’ are hereby stands deleted from the ‘Limitations of use of Vehicle’, as described under ‘Your Duties’ for the period and event as described below – Period: From…<Insert date> till <insert date> Event: …<insert name of the event> to be held at …<insert place or route> and organized by <insert organizer’s name>. During the course / period of the described event any liability (including personal accident) towards the occupant is not covered. This endorsement will not cover any liability of organizers. Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 14: Use of Commercial Vehicle for Private Purpose The policy shall remain operative for following benefits, if covered otherwise and shown on your policy, whilst the vehicle insured is being used for private and social purpose Benefit: Own Damage and Group Group: Occupant’s Personal Accident (Refer IME 7 attached) Group: Extended Legal Liabilities – Occupant of the Vehicle (Refer IME 8 attached) We will also indemnify you for your legal liabilities, not being a liability under the Motor Vehicles Act, 1988, towards injury / death to any person being carried in the vehicle (including mounting on or dismounting from the vehicle) at the time of accident under The Fatal Accident’s Act, 1855 or at Common Law (as amended as on the date of this endorsement) provided that such person is neither your employee nor carried for a fare. Other particulars / terms / conditions / warranties of the policy remain unchanged. IME 15: Indemnity to Hirer The coverage of the policy is extended to indemnify any hirer against loss / damage or liability in connection with the vehicle arising from negligence of you or any of your employee, while the vehicle is given on hire under an agreement provided hirer complies with and fulfills the requirements mentioned in the policy under clause ‘Your Duties’. IME 16: Hired Vehicle and Driven by Hirer If you enter into an agreement of hire with a person (hereinafter called the Hirer), where you give the vehicle to the hirer and the same be driven by the hirer or any other person of hirer’s choice, this policy shall remain operative only if you fulfill following requirements – Hirer has provided the requisite information in the prescribed format with his signature. Hirer undertakes to comply with the requirements mentioned in the policy under clause ‘Your Duties’. Both of the above are provided to us prior to start of such agreement. In addition – We will not be responsible for any loss or damage from theft or conversion of the vehicle in <whole or>* part thereof by hirer. Policy would be subject to an Imposed Excess of ` … for any claim under Benefit: Own Damage Policy would be suspended if the hirer uses the vehicle for carriage of passengers for fare. Other particulars / terms / conditions / warranties of the policy remain unchanged. May be deleted by insurer. IME 17: Overturning Risk for Construction Equipment Vehicle We will not be responsible for – Any loss or damage caused by overturning of the vehicle, while the vehicle is in operation and such overturning is arisen due to use of any MOTOR INSURANCE
  • 11. 96 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA tool, plant or fixture whether forming part of the vehicle or attached thereto. This clause is limited to the peril ‘Accident while driven or parked’ and / or ‘Landslide or Rockslide’.* Any liability of whatsoever nature beyond ‘Benefit: Mandatory Legal Liability’. * Insurer should delete if ‘Benefit: Own Damage’ is not covered. SECTION 3: Warranties IMW 1: Membership of Recognized Automobile Associations Warranted that you will inform us if you cease to be a member of declared Automobile Association and pay us required additional premium. If you fail to do so; any claim would be subject to additional Imposed Excess of `. IMW 2: Anti Theft Device Warranted that you will take all steps to keep the anti theft device in working condition at all times. If it is found that at the time of theft of the vehicle, such device was not in working condition; such claim would be subject to additional Imposed Excess of `. IMW 3: Limited Use Warranted that vehicle would be used only within the informed insured’s own premises / site. We will not be liable for any claim arising beyond the limits of such premises / site. IMW 4: Private Carrier Warranted that vehicle would only be used to transport goods belonging to you and your business. If it is found that the time of loss / damage, the vehicle being used for transport of goods other than yours and your business, policy would be subject to an additional Imposed Excess of …% of the claim amount. IMW 5: Good Driving / Accident / Claim History Premium for the policy has been calculated basis your declaration – a. That the vehicle has no accident or claim for last … years and not more than … accident or claim since you purchased the same. b. That the main driver has no accident for last … years and not more than … accident/s or claim/s since he/she obtained the driving license. Warranted that if the above information is found to be incorrect, your claim would be reduced by 25% of the assessed amount. Guide Policy Wording for Motor Insurance in India Welcome Clause We welcome you for choosing us for insuring your vehicle and related liabilities… <Company specific information> Please note that this is a legal contract between you and us. It is important that you go through this document carefully and – check the correctness of the details mentioned in the schedule about you and your vehicle check the coverage and exclusions offered according to what were solicited by you and committed by us or our authorized agent at the time of solicitation of insurance check the premium for its completeness as paid by you check the copy of the proposal that you submitted or transcript of information you provided over phone / verbal at the time of soliciting this insurance Having Any Query? You May Reach Us You can reach us through any of below modes, if you require any clarity / help Contact your agent / broker <Agent / Broker Name, Code and Contact Number> Contact our branch office at <Policy Issuance Office> Call us at <Call Centre Number> Email us at <Customer Support Email ID> Write to us at <Customer Support Address> Visit us at <Website> What Comprises Your Legal Motor Insurance Policy Information given by you, in proposal form, telephonic call, verbal or through any other means, at the time of soliciting this insurance. Covernote, if any, issued by our authorized agent / employee, that is mentioned in the schedule of policy. MOTOR INSURANCE
  • 12. 97JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Schedule of policy Certificate of insurance issued in accordance of the Motor Vehicles Act, 1988 Clauses, conditions, endorsements, warranties as given in subsequent pages under sub headings – Rights and Duties Coverage / Perils in scope Coverage / Perils out of scope Conditions Applicable Claim Procedures and Governance Endorsements & Warranties Any further endorsement on the policy as per your request effective ab-initio or a later date. Rights and Duties Your Rights – You have the rights To be provided with premium charged benefit-wise To choose for an electronic, soft copy or hard copy of your policy To be explained the computation of compensation on happening of a claim To be explained the reasons in detail, if company declines a claim To approach us if you feel cheated at any time or are not satisfied with the product or services of the company or find us not fulfilling our duties to your satisfaction. Please refer the Grievance Redressal Section for the information. Your Duties – You shall fulfill these duties at all times. Non fulfillment of any or all may lead to this contract being void or voidable on our part resulting in to repudiation of your claims under the policy. Disclosures All information provided at the time of soliciting this insurance or later must be complete, true and correct to the best of your knowledge. Any change in the subject matter or any other related information must be provided to us as early as possible and within reasonable time. Reasonable Care You shall take all reasonable steps to safeguard the vehicle from loss or damage of any kind as if it is uninsured. You shall use (or allow the use of) the vehicle on public place only if the vehicle is in efficient and roadworthy condition and comply with provisions of the Motor Vehicles Act, 1988. In the event of any accident or breakdown: You shall not left the Insured Vehicle unattended without proper precaution being taken to prevent any further loss or damage. You shall not allow use of the vehicle prior to necessary repairs are carried out to bring it in roadworthy condition. Limitations of Use of Vehicle – You shall not drive or allow anybody to drive the vehicle unless the person driving is allowed to drive the class of vehicle by the respective authorities by way of a valid driving license. You shall not use the vehicle in contravention of its registration class, permit and fitness as explained in Motor Vehicles Act, 1988. You shall not use the vehicle in connection with any of the following activities unless you have given us a prior notice and we have allowed you in writing – Organized Racing Pace Making Speed Testing Reliability Trials or Rallies Motor Trade Our Rights – We have the rights To examine the vehicle or driver at any time with prior notice. To ask for all reasonable information and assistance, which to our knowledge, may impact our decision on a claim or its quantum payable. To arrange for a representation at any Inquest or Fatal Injury, which may be subject to indemnity under the policy. To undertake the defense of proceedings in court of law for any alleged offence that may be subject to indemnity under the policy. MOTOR INSURANCE
  • 13. 98 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Our Duties – We will provide you all clarifications and support on policy related matters for pressing any endorsement and / or claim as and when required. We will provide you clear reasoning, if we decline your claim at any point of time. We will provide you full calculation of compensation payable under a claim Coverage / Perils in Scope Benefit: Mandatory Legal Liabilities – We will indemnify you for – Your legal liabilities in respect of death or bodily injury to a person or damage to property of a third party caused by or arising out of the use of insured vehicle in a public place as may be established under and subject to provisions of Motor Vehicles Act, 1988 as amended on the date of inception date of the policy Legal liabilities as provided for under above provision, would include liabilities of driver of the vehicle within the provision of the policy and / or Motor Vehicles Act, 1988 Your costs and expenses incurred with our prior consent Special Provisions to this Benefit Any occupant carried in the vehicle, who is not a dependent upon you, shall be eligible for indemnity under above provisions, provided vehicle is registered and used as a Non-Transport vehicle and such occupant is not an employee of you under the provisions of Workmen’s Compensation Act, 1923. No provision of this policy shall affect the rights of any person, who has the rights to be indemnified or recover any amount under the provisions of the Motor Vehicles Act, 1988. However, you shall pay us all such sums, which we would have not liable to pay otherwise. If there is more than one person, having rights for indemnity, any limit as mentioned in the policy shall apply to aggregate amount of indemnity of all such persons according to priority set by you. Benefit: Own Damage – If the insured vehicle (including any accessories and bi-fuel kit as long as the same is found fitted on the vehicle at the time of accident and is shown on the schedule) suffers any loss or damage by any of the following, we will pay you for such loss and damages, subjects to exclusions mentioned – Group: Fire & Allied Perils – Fire Explosion Self Ignition Lightening Group: Accident or Transit Accident while driven or parked Whilst in transit by road, rail, air, inland-waterway, lift, elevator. This cover is not available if such transit is for ferrying the vehicle outside India. Group: Theft or Housebreaking Group: Act of God Covers – Earthquake (Includes damage by Fire and / or shock) Landslide or Rockslide Flood, Inundation, Strom, Hailstorm, Frost, Tsunami or related perils Group: Damages by any Person or Activity – Malicious Activity Riots or Strike Terrorism Group: Towing charges, if necessitated and incurred subject to limits mentioned in the schedule of policy Group: Additional Add-On Covers – … … <Include company specific add-on cover that is applicable for damage to the vehicle> (Mention only those groups, which are covered) Benefit: Extended Liabilities or Personal Accident – Group: Occupant’s Personal Accident (Refer IME 7 attached) Group: Extended Legal Liabilities – Occupant of the Vehicle (Refer IME 8 attached) Group: Extended Third Party Property Damage Cover (Refer IME 9 attached) MOTOR INSURANCE
  • 14. 99JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Group: Legal Liability of the Insured (Applicable for a policy issued without Mandatory Legal Liabilities Cover as per Rule 8.0 of the guide) (Refer IME 10 attached). Group: Additional Add-On Cover <Include company specific add-on cover that is applicable for any kind of liability> (Mention only those groups, which are covered) Coverage / Perils out of Scope If we observe that you fail to fulfill your duties at the time of occurrence of loss or damage and / or arisen of liability Any Consequential loss, depreciation, wear and tear, mechanical and / or electrical breakdown, failures or breakages Loss of or damage to tyres and tubes unless the Insured Vehicle is damaged at the same time Any accidental loss or damage and / or liability suffered whilst driver of the vehicle is under the influence of intoxicating liquor or drugs Loss or Damage and / or liability caused, sustained or incurred outside the territorial limits as mentioned or endorsed Any kind of contractual liability Any loss or damage and / or liability directly or indirectly caused by or contributed to by or arising from ionizing, radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception combustion shall include any self sustaining process of nuclear fission Any loss or damage or liability directly or indirectly caused by or contributed to by or arising from nuclear weapons material Any loss or damage and / or liability directly or indirectly or proximately or remotely occasioned by, contributed to by or traceable to or arising out of or in connection with war, invasion, the act of foreign enemies, hostilities or warlike operations (whether before or after declaration of war), civil war, mutiny, rebellion, military or usurped power or by any direct or indirect consequence of any of the said occurrences and in the event of any claim hereunder the insured shall prove that the accidental loss or damage and / or liability arose independently of and was in no way connected with or occasioned by or contributed to by or traceable to any of the said occurrences or any consequences thereof and in default of such proof, We shall not be liable to make any payment in respect of such a claim. Conditions Applicable Territorial Limits Policy is valid throughout India and shall include countries, if any, included by way of endorsement attached. Vehicle Requisitioned by Government In a situation of vehicle being requisitioned by the Indian Government (including State or Local Government) under any legal provisions, you would enjoy continue cover under this policy. However, in case of any loss / damage / arisen of any liability during the period of such requisition, we will settle the claim under normal circumstances and you would require to pay us back any amount recovered from the Government or subrogate your rights to us for any known or future amounts recoverable from the Government. Cancellation of Policy You may cancel this policy any time before expiry by giving written notice and there has been no claim on the policy, you would be eligible for a refund of premium (No refund, if policy was taken for a term of less than one year) as under – If you have another policy for same vehicle and same sum- insured with us – Full Premium Paid (if other policy is incepting earlier and is in force) less administrative charges of ` 100/- If you have another policy for same vehicle and same sum- insured with other insurer – Pr- rata premium refund for unexpired period less administrative charges of ` 100/- MOTOR INSURANCE
  • 15. 100 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA If you do not have any other policy – We will retain full premium for mandatory legal liability cover. For rest of the premium, refund of premium for unexpired period would be made at below rates (of annual premium) Less than 4 months 0% Less than 8 months 40% Less than 5 months 10% Less than 9 months 50% Less than 6 months 20% Less than 10 months 60% Less than 7 months 30% Less than 11 months 70% Less than 12 months 80% If you sell the vehicle before expiry and submit the other insurance proof of the vehicle – Pro-rata Premium Refund for the remaining period. If you sell the vehicle before expiry but do not submit the other insurance proof of the vehicle (and do not provide NOC to new owner) – Pro-rata Premium Refund (after retaining premium for mandatory legal liability cover) for the remaining period. We may cancel this policy any time before expiry by giving 15 days notice to you and you would be eligible for a refund of premium as under – If we cancel on grounds of any fraudulent act, mis-representation, mis-declaration, non-cooperation by or from you – NIL. For any other reason – Pro- rata Premium Refund for the remaining period calculated from 16th day of the notice. Transfer of Policy If you sell the insured vehicle before expiry of the policy, whether recorded on RC or not, following provisions would apply with immediate effect – Policy would stand suspended except for mandatory legal liability cover. If you do not want to pass on the insurance to new owner, you may apply for refund of premium as per condition ‘Cancellation of Policy’. If you pass on the insurance to new owner, please provide NOC (your consent letter) to new owner and the new owner can apply for transfer of this insurance in his name by submitting following documents / information and required premium – Your consent letter Original Certificate of Insurance Fresh proposal form duly filled in and signed by the new owner Inspection of the vehicle, if required by us Deposit of additional premium, if any required by us plus ` 50/- towards administrative charges. Notes – If this application is not submitted within 14 days from date of purchase, policy would stand suspended except for mandatory legal liability cover If this transfer of policy is required because of death of the owner and such transfer is to be effected in the name of your legal heir / next kin, subject to following provisions – Legal heir / next kin must apply for transfer in his / her name with following documents / information within 90 days, but before expiry of the policy, of death of owner – Owner’s death certificate Legal Heir Certificate or Transferred RC with relationship proof Else policy would stand suspended except mandatory legal liability cover from the 91st day (if policy not expired earlier) till expiry of policy. Insured / new owner would not be eligible for any extension of policy period for the number of days policy is kept under suspension. Substitution of Vehicle If you purchase a new vehicle and wish to substitute the new vehicle under the policy , you may request for the same with following document / information and by depositing the required premium – Proof of insurance for the Insured Vehicle MOTOR INSURANCE
  • 16. 101JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Fresh proposal form in respect of new vehicle Premium, as may be required by us. This would be the difference of premium required for new vehicle less premium paid calculated on pro-rata basis for the remaining period of insurance. Extension of Policy Period Policy Period can be extended by us upon your written request to arrive at a common expiry date convenient to you provided you pay us pro-rata premium for such extended period and your consent that you shall renew the insurance with us for full 12 months upon expiry of such extended period, failing which you shall pay us the difference between the Short Period Rates and the pro-rata premium then paid. Vehicle Laid-Up If you wish to stop usage of the vehicle for certain period and lay- up the vehicle in garage with or without surrendering the Registration Certificate to respective authorities, you shall be eligible for following benefits – If such lay-up is with surrender of Registration Certificate – You may get the policy period extended by the lay-up period. You may opt for pro-rata credit of premium for the lay-up period. If such lay-up is without surrender of Registration Certificate – You may opt for surrendering the coverage (one or more groups) under the ‘Benefit: Own Damage’ and / or ‘Benefit: Extended Liabilities or Personal Accidents’ and shall be entitle for pro-rata credit of premium for respective benefits for the lay-up period. Notes: Lay-up must not be as a result of any event giving rise to a claim under the policy and lay-up period must not be less than 60 consecutive days. This can be opted only once during the currency of the policy including any extended period. The credit of premium can be utilized against the renewal premium of the policy. This cannot be availed in cash in any circumstances except where vehicle is sold during the currency of such lay-up period. Claims Procedures and Governance Notification of Claim Upon occurrence of any incidence that may give rise to a claim under the policy: You shall report to us at the earliest and within reasonable time through any recorded means of communication like phone call, email, letter, online etc. You shall report the matter to police, if there is a cognizable offence like third party death / injury / damage, theft or malicious damage etc. A copy of the report must be provided to us. Report to police is not mandatory for collision with other motor vehicle without any third party death / injury. You shall provide all such information and assistance as may be required by us or by our authorized surveyor, which may affect our decision on claim or quantum of claim. You shall take due care and preserve the damaged property for our inspection as also to avoid any further damage or loss. In case the incidence involves any form of legal process: You shall immediately send us every written notice or information of any verbal notice of a claim. You shall immediately send us any letter, claim, writ, summons, or other legal process received by you. You shall permit us to take over the control and conduct of the defence, pursuit or settlement of any claim and provide us or our representatives with such cooperation and assistance as may be required for that purpose. You shall not, without our prior written consent, incur any costs, admit liability for or attempt to settle, make any admission, offer any payment or otherwise assume any contractual obligation with respect to any legal action or threat of legal action. MOTOR INSURANCE
  • 17. 102 JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Documents Required Usually following documents are required for a claim. However, depending on the situation and merits, we may ask for more information / documents – Claim under Benefit: Own Damage Claim Form duly filled in Self attested copy of Vehicle Registration Certificate and original for verification Self attested copy of driver’s Driving License and original for verification Self attested copy of Vehicle Permit and Fitness and original for verification Copy of Police First Information Report, if any Claim under Benefit: Third Party In addition to above documents Copy of the plaint received Copy of Police First Information Report. Detailed explanation about the situation in which accident / loss happened. Basis of Settlement for a Claim All claims would be settled only in India Rupees. It would be our right to decide on whether a claim is to be settled as a total loss or partial loss. In case of a total loss (including theft), you would be eligible for payment of Sum-Insured as mentioned in the schedule – In full after deducting excess. In which case the wreck of the vehicle including its registration rights would be subrogated to us. After deducting excess and salvage value of the wreck. In which case you would retain the wreck, however, this policy will be deemed to be cancelled from next day of the loss occurring event. In case of a partial loss (including theft of part of the vehicle) – We would have rights to decide on reinstate, replace, repair or refurbish a particular part or accessory. If any part is replaced with new, depreciation at below rates would be deducted. Claim would be settled only after all allowed repairs or replacements are carried out unless we decide to settle the claim for cash in which case you would be eligible to retain salvage but policy will be deemed to be cancelled from next day of the loss occurring event. In case there is more than one insurance on the vehicle covering the peril occurred, we will pay only a rateable proportion of the admissible claim. Deductions from the Claim Amount Depreciation We will deduct the depreciation at following rates in respect of parts replaced Main material, the respective part is made of Rates Rubber / Nylon / Plastic, Tyres, Tubes, Batteries, Airbags 50% Fibre Glass 30% Glass 0% Painting: Material Cost of the Painting Charges (In case Material Cost is not separately mentioned in Painting Bill, 25% of total Painting Charges would be considered as material) 50% All other, including wooden), as per the following schedule based on age of the vehicle as computed from the date of purchase or date of registration, whichever is earlier: Not exceeding 6 months 0% Exceeding 6 months but not exceeding 1 year 5% Exceeding 1 year but not exceeding 2 years 10% Exceeding 2 years but not exceeding 3 years 15% Exceeding 3 years but not exceeding 4 years 25% Exceeding 4 years but not exceeding 5 years 35% Exceeding 5 years but not exceeding 10 years 40% Exceeding 10 years 50% MOTOR INSURANCE
  • 18. 103JANUARY-MARCH 2015 THE JOURNAL OF INSURANCE INSTITUTE OF INDIA Excess / Franchise – A Sum of amounts as mentioned in the schedule of policy under heading excess. Excess may be applicable to all benefits, any particular benefit or any particular peril, as mentioned in the schedule of policy. Excess may additionally be applicable as mentioned in any warranty Franchise, if any mentioned on the schedule, is the amount up to which no claim is payable. Claim, greater than this amount, are paid in full. Special Deductions for Commercial or Transport Vehicles – A vehicle covered under any sub classification of section 2.2.2 (excluding classes 2.2.2.1.1, 2.2.2.2.1, 2.2.2.2.2, 2.2.2.2.3 & 2.2.2.2.4) shall be subject to special exclusion of loss of or damage to lights, tyres, tubes, mudguards, bonnet side parts, bumpers and paints. In case of settlement of claim as partial loss, no amount would be paid towards repair / replacement / refurbishment of these parts. <This special deduction clause is not compulsory and may be omitted by the insurer> Grievance Redressal Arrangements If you feel that you are cheated at any time or are not satisfied with the product or services of the company or find us not fulfilling our duties to your satisfaction, please approach any of the below authorities for redressal – Your agent whom you solicit this insurance or who has been assigned by the company for serving you Company’s Branch or Customer Service Officer through phone call, email, online, letter or in person as given under Reach Us on Welcome Clause Company’s Grievance Redressal / Escalation System Regulator, IRDA, through IGMS Insurance Ombudsman of your Area Consumer Grievance Redressal Forums, set up under the Consumer Protection Act, 1986 - Any other means as provided by various Ministries of Indian / State Government for lodging a complaint or any other empowered judiciary Endorsements & Warranties <Insert as required> General Information Your Premium Premium computation for your vehicle is dependent upon various factors. These may vary insurer to insurer. You may ask for details of these factors and various components of the premium benefit-wise. It is important that you provide complete and true information against questions / points / columns in the proposal form or otherwise. Any incorrect information provided by you before or after obtaining this insurance may lead to this contract being voidable on our option. Your premium is calculated on a particular excess. You may reduce your premium by opting for an extra excess. The higher the excess you choose, the lower the premium you pay. Renewal of Your Policy It is mandatory to carry a valid policy of insurance all the time as per the provisions of Motor Vehicles Act, 1988. It is important that you renew the insurance before expiry of this policy. Though we may send you reminder before policy renewal date using various means e.g. letter, email, sms, phone etc. yet you shall set your own reminders for the renewal date to ensure timely renewal. TJ References Tariff Advisory Committee (2002) India Motor Tariff. Insurance Regulatory and Development Authority (various dates) Circulars related to Motor Insurance / India Motor Tariff from www.irda.gov.in. Peeyush Agarwal (2013). Motor Insurance in India – New Vistas. Asia Insurance Review. January 2013 P.58-59. http://www.asiainsurancereview.com/ Magazine/ReadMagazineArticle?aid=33226. MOTOR INSURANCE